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Healing II: Complications01:24

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Complications during healing arise when tissue repair is altered by local or systemic factors. These changes involve abnormal collagen deposition, altered biomechanics, and reduced vascular supply, impairing restoration of normal structure and function.Loss of FunctionScar tissue differs significantly from the original tissue it replaces. In the skin, fibrosis lacks adnexal structures such as hair follicles, sebaceous glands, and sweat glands. Their absence reduces tactile sensitivity, impairs...
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Updated: Apr 19, 2026

Surgical Fixation of Sternal Fractures: Preoperative Planning and a Safe Surgical Technique Using Locked Titanium Plates and Depth Limited Drilling
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Complications after sternal reconstruction: a 16-y experience.

Jeffrey H Kozlow1, Shaun P Patel1, Sameer Jejurikar1

  • 1Section of Plastic Surgery, Department of Surgery, University of Michigan Health System, Ann Arbor, Michigan.

The Journal of Surgical Research
|December 27, 2014
PubMed
Summary

Obesity and female gender are key risk factors for major complications and reconstructive failure after sternal wound reconstruction. Understanding these factors is crucial for improving patient outcomes following cardiac surgery.

Keywords:
ComplicationsFlapReconstructionRisksSternalWound

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Area of Science:

  • Cardiothoracic Surgery
  • Plastic and Reconstructive Surgery

Background:

  • Risk factors for sternal complications post-sternotomy are known, but those for sternal reconstruction remain less understood.
  • This study addresses the gap in knowledge regarding complications and risk factors specific to sternal reconstruction procedures.

Purpose of the Study:

  • To investigate complication rates following sternal wound reconstruction.
  • To identify perioperative risk factors associated with major complications and reconstructive failure after sternal reconstruction.

Main Methods:

  • A retrospective review of 230 patients undergoing sternal reconstruction with muscle flaps post-cardiac surgery.
  • Evaluation of patient demographics, comorbidities, and operative details against outcomes of major complications and reconstructive failure.

Main Results:

  • Major complications occurred in 33% of patients, with a 3.5% mortality rate. Obesity, COPD, and reconstructive procedure type were linked to increased major complications.
  • Reconstructive failure occurred in 17% of patients, associated with female gender, obesity, prior CABG, and left internal mammary artery use.
  • Obesity independently increased the risk of major complications, while female gender independently increased the risk of reconstructive failure.

Conclusions:

  • Unlike traditional sternal wound risk factors, obesity and female gender are independently associated with adverse outcomes after sternal reconstruction.
  • These findings highlight specific patient characteristics that require attention to mitigate risks in sternal wound reconstruction.