Asian Annals
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Sumit Narang
Amit Banerjee
Deepak K Satsangi
Muhammad A Geelani
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ORIGINAL ARTICLE

Sternal Weave in High-Risk Patients to Prevent Noninfective Sternal Dehiscence

Sumit Narang, MCh, Amit Banerjee, MCh, Deepak K Satsangi, MCh, Muhammad A Geelani, MCh

GB Pant Hospital, Maulana Azad Medical College, New Delhi, India

Sumith Narang, MCh, Tel: +91 129 4086920, Fax: +91 11 26672594; Email: sumit_narang{at}yahoo.com, House No. 127, Sector 7 A, Faridabad, Haryana 121006, India.

ABSTRACT

Dehiscence of the sternum is a serious and potentially devastating complication. The purpose of this prospective study was to determine whether a prophylactic sternal weave would decreased the incidence of noninfective sternal dehiscence, compared to routine sternal closure, in a high-risk group. Between 2000 and 2007, 200 patients undergoing median sternotomy for cardiac surgery, with one or more risk factors including New York Heart Association functional class III/IV, chronic obstructive pulmonary disease, osteoporosis, obesity, and off-midline sternotomy, were randomly assigned to group A (sternal weave closure, 100 patients) or group B (routine sternal wire closure, 100 patients). No patient in either group with a single risk factor had sternal dehiscence. The incidence of noninfective sternal dehiscence was significantly less in group A than group B in patients with 2 or more risk factors (2.5% vs. 12.5%). Routine sternal closure is sufficient in patients with a single risk factor, whereas a prophylactic sternal weave should be carried out in all patients with 2 or more risk factors, to decrease postoperative morbidity.

Key Words: Sternum • Thoracic Surgical Procedures • Wound Healing

Asian Cardiovasc Thorac Ann 2009; 17:167-170
© 2009 by SAGE Publications
DOI: 10.1177/0218492309103306




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