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Pericardial flap prevents sternal wound complications
W C Nugent1, E L Maislen, G T O'Connor
1Department of Surgery, Dartmouth Hitchcock Medical Center, Hanover, NH 03756.
Archives of Surgery (Chicago, Ill. : 1960)
|May 1, 1988
Summary
Using a pericardial flap between the heart and sternum effectively prevents mediastinitis and sternal wound dehiscence after cardiac surgery. This simple technique enhances sternal healing and patient safety.
Area of Science:
- Cardiovascular Surgery
- Thoracic Surgery
- Surgical Innovation
Background:
- Mediastinitis and sternal wound dehiscence are significant complications following cardiac surgery.
- Previous surgical techniques had an overall incidence of 2.73% for these complications.
Purpose of the Study:
- To evaluate the efficacy of interposing a pericardial flap to prevent mediastinitis and sternal dehiscence.
- To assess the safety and impact of this surgical technique on sternal healing.
Main Methods:
- A retrospective analysis comparing outcomes before and after the adoption of a pericardial flap technique.
- Data collected from January 1984 to mid-1986 (pre-flap) and during mid-1986 (post-flap).
- Comparison of complication rates between surgeons using and not using the pericardial flap.
Main Results:
- Before flap use, mediastinitis/dehiscence incidence was 2.73% (26/952 patients).
- After adopting the pericardial flap, 0 out of 270 patients developed mediastinitis or sternal dehiscence.
- A statistically significant reduction in mediastinitis was observed in patients receiving the pericardial flap compared to those who did not.
Conclusions:
- The routine use of a pericardial flap is a safe and effective method for preventing mediastinitis and sternal dehiscence.
- This technique facilitates sternal healing and improves patient outcomes after cardiac surgery.
- No complications were attributed to the pericardial flap construction.