Sternal dehiscence in patients with and without mediastinitis
P M Boiselle1, A V Mansilla, C S White
1Department of Radiology at Beth Israel Deaconess Medical Center, Boston, MA 02215, USA. pboisell@caregroup.harvard.edu
Journal of Thoracic Imaging
|April 9, 2001
Summary
Sternal dehiscence (SD) patients with mediastinitis present later post-surgery. Sternal wire abnormalities on chest radiographs (CXR) are common in SD, with or without mediastinitis, showing no significant difference between groups.
Area of Science:
- Cardiothoracic Surgery
- Radiology
- Infectious Disease
Background:
- Sternal dehiscence (SD) is a serious complication following sternotomy.
- Mediastinitis, a deep sternal wound infection, increases morbidity and mortality in SD patients.
- Radiographic assessment of sternal wires is crucial for diagnosing SD.
Purpose of the Study:
- To compare patients with SD and mediastinitis versus those with isolated SD.
- To analyze the time interval from surgery to SD diagnosis.
- To evaluate the frequency and timing of sternal wire abnormalities on chest radiographs (CXR).
Main Methods:
- Retrospective chart review of SD patients (January 1993 - April 1999).
- Comparison of initial postoperative CXR with CXR at SD diagnosis.
- Assessment for sternal wire displacement, rotation, and disruption.
Main Results:
- Sternal wire abnormalities are evident in most SD patients, irrespective of mediastinitis.
- No significant difference in the frequency of sternal wire abnormalities between SD with and without mediastinitis groups.
- Patients with SD and mediastinitis presented later postoperatively than those with isolated SD.
Conclusions:
- Radiographic sternal wire abnormalities are common in sternal dehiscence.
- The timing of presentation differs between SD with mediastinitis and isolated SD.
- CXR is valuable in evaluating sternal wire integrity in post-sternotomy patients.
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