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A review of sternal wound complications in a military hospital
J G Enad1, D E Amundson, W E Walker
1Department of Critical Care Medicine, Naval Hospital, San Diego, CA 92134-5000.
Insights
Sternal wound complications occurred in 3.0% of patients after coronary artery bypass surgery. Male, obese, hypertensive patients with a smoking history faced higher risks, but internal mammary artery use showed no association.
Area of Science:
- Cardiovascular Surgery
- Thoracic Surgery
- Surgical Infections
Background:
- Sternal wound complications are a significant concern following coronary artery bypass grafting (CABG).
- Identifying patient-specific risk factors is crucial for preventing adverse outcomes.
- Previous studies have explored various risk factors, including patient demographics and surgical techniques.
Purpose of the Study:
- To review the incidence and characteristics of sternal wound complications after CABG.
- To identify associated patient risk factors.
- To evaluate the role of internal mammary artery harvesting in sternal wound complications.
Main Methods:
- A retrospective review of 168 patients undergoing CABG with saphenous vein grafts over 13 months.
- Data collection included patient demographics, comorbidities, surgical details, and postoperative outcomes.
- Statistical analysis to identify factors associated with sternal wound complications.
Main Results:
- Five patients (3.0%) developed sternal wound complications.
- Associated factors included male gender, obesity, hypertension, and a history of smoking.
- All patients recovered and were discharged.
- No association was found between sternal wound complications and internal mammary artery harvesting.
Conclusions:
- Sternal wound complications after CABG, while infrequent, are linked to specific patient risk factors.
- Obesity, hypertension, smoking, and male gender are important considerations.
- Internal mammary artery harvesting does not appear to increase the risk of sternal wound complications in this cohort.
Abstract:
A retrospective review of sternal wound complications was conducted during a recent 13-month period at the Naval Hospital, San Diego. These complications developed in 5 (3.0%) of 168 patients after they underwent coronary artery bypass with saphenous vein grafts. Three or more of these patients were male, obese, and hypertensive, with a significant smoking history. All these factors have been previously reported to be associated with an increase in the incidence of sternal wound complications. All patients had prolonged postoperative intensive care treatment, and ultimately all patients recovered and were discharged from the hospital. Interestingly, as opposed to other reviews, we were unable to show an association of sternal wound complications with the use of internal mammary artery harvesting.