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Sternal Wound Complications: Objective Reclassification and Surgical Reconsideration.
- Source :
-
The heart surgery forum [Heart Surg Forum] 2020 Feb 27; Vol. 23 (1), pp. E076-E080. Date of Electronic Publication: 2020 Feb 27. - Publication Year :
- 2020
-
Abstract
- Background: Sternal wound complications pose a tremendous challenge post-cardiac surgery. There’s no consensus or clear guidelines to deal with them. We propose that simple and more objective classification helps to organize the range of sternal wound complications and suggest a relevant treatment strategy.<br />Methods: One-hundred-sixteen cases of sternal wound complications retrospectively were reviewed out of 2,391 adult patients, who underwent full sternotomy during cardiac surgery from 2006 to 2018. Eighty-six cases conservatively were managed and the remaining 30 cases required surgical intervention. More objective classification was proposed and less invasive fasciocutaneous flap was considered for nearly all reconstructive procedures.<br />Results: The incidence of sternal wound complications was 4.8%. Conservative management was adopted for 86 cases, mean duration was 11.19 ± 9.8 days. Surgical management was performed in 30 patients (25.86%); 28 (93.3%) of whom recovered with good outcomes with less invasive fasciocutaneous flap done for 13 cases. Two cases had recurrence; one conservatively was managed and other was reoperated and healed well. The most common organisms in recurrent infections were N. coagulase (29.8%), Klebsiella (12.5%), pseudomonas (10.5%), and MRSA (10.5%). We had 4 mortalities. None of the mortalities were related to sternal wound complications; one was related to the cardiac surgery.<br />Conclusions: Sternal wound complications are grave events. Objective classification and proper management selection will gain better outcomes.
- Subjects :
- Aged
Cardiac Surgical Procedures adverse effects
Conservative Treatment
Female
Humans
Male
Middle Aged
Reoperation
Retrospective Studies
Surgical Flaps
Surgical Wound Dehiscence diagnosis
Surgical Wound Infection diagnosis
Sternotomy adverse effects
Surgical Wound Dehiscence classification
Surgical Wound Dehiscence surgery
Surgical Wound Infection classification
Surgical Wound Infection surgery
Subjects
Details
- Language :
- English
- ISSN :
- 1522-6662
- Volume :
- 23
- Issue :
- 1
- Database :
- MEDLINE
- Journal :
- The heart surgery forum
- Publication Type :
- Academic Journal
- Accession number :
- 32118548
- Full Text :
- https://doi.org/10.1532/hsf.2649