Do external support devices reduce sternal wound complications after cardiac surgery?

A best evidence topic in cardiac surgery was written according to a structured protocol. The question addressed was whether external support devices reduce sternal wound complications after cardiac surgery with sternotomy. Altogether 116 papers were found using the reported search, of which six presented the best evidence to answer the clinical question. The author, year, journal, study type, patient group studied, relevant outcomes, results and study weaknesses are tabulated. Six randomized controlled trials investigating the effect of external chest support devices on sternal wound complications in adult patients undergoing sternotomy for cardiac surgery were selected. These studies demonstrate a significant reduction of deep sternal wound complication on comparing external support with no support. Non-elastic devices were more effective in reducing sternal complication compared with the elastic bandage (four trials). Three studies reported significant reduction of mean hospital stay in patients receiving non-elastic chest support devices. We conclude that early post-sternotomy use of an external non-elastic sternal support device reduces overall sternal wound complications and may reduce the hospital length of stay.