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Related Experiment Videos

Sternal dehiscence. Early detection by radiography

R H Hayward1, W L Knight, C G Reiter

  • 1Texas A & M University Health Science Center College of Medicine, Scott and White Clinic, Temple.

The Journal of Thoracic and Cardiovascular Surgery
|October 1, 1994
PubMed
Summary

Radiographic examination of sternal wires can detect median sternotomy separation early. Subtle or gross changes in wire position on chest X-rays indicate potential sternal separation, aiding timely diagnosis.

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Area of Science:

  • Cardiovascular Surgery
  • Radiology
  • Thoracic Imaging

Background:

  • Median sternotomy is a common surgical approach for cardiac procedures.
  • Sternal wound complications, including separation, can occur post-operatively.
  • Early detection of sternal separation is crucial for patient outcomes.

Purpose of the Study:

  • To identify radiographic indicators of threatened median sternotomy closure separation.
  • To evaluate the utility of sternal wire topography in diagnosing sternal dehiscence.
  • To determine if radiographic changes precede clinical detection of sternal separation.

Main Methods:

  • Retrospective review of postoperative chest roentgenograms in two patient groups.
  • Group A: 50 consecutive cardiac surgery patients without clinical sternal problems.

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  • Group B: 10 patients with clinically diagnosed sternal separation.

    • Main Results:

    • In Group A, subtle radiographic changes in sternal wires were observed in some patients.
    • In Group B, radiographic changes in sternal wire position preceded clinical diagnosis of separation by 1-8 days.
    • Four common radiographic patterns of sternal wire changes were identified.

    Conclusions:

    • Radiographic scrutiny of sternal wire topography is essential after median sternotomy.
    • Subtle and gross changes in sternal wire position are reliable indicators of sternal separation.
    • Radiologists and surgeons must carefully examine sternal wires on postoperative roentgenograms.