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[The long-term anterior chest median wound keloid after the cardiac surgery]
M Hibi1, M Kawamura, H Ohshima
1Division of Surgery, Aichi Prefectural Owari Hospital, Ichinomiya, Japan.
Insights
Cardiac surgery patients using bilateral internal thoracic arteries face a higher risk of developing keloids on their anterior chest median wounds. This may be linked to reduced blood supply, impacting wound healing and scar formation.
Area of Science:
- Cardiovascular Surgery
- Dermatology
- Wound Healing
Context:
- Keloid formation is a common complication following sternotomy in cardiac surgery.
- The anterior chest median wound is susceptible to keloid scarring.
- Patient-reported outcomes are crucial for understanding long-term surgical complications.
Purpose:
- To investigate the incidence and risk factors of long-term anterior chest median wound keloid after cardiac surgery.
- To explore the correlation between internal thoracic artery usage and keloid development.
- To identify potential mechanisms, such as compromised blood supply, contributing to keloid formation.
Summary:
- A questionnaire-based study analyzed long-term keloid formation in anterior chest median wounds post-cardiac surgery.
- A significantly higher risk of keloid development was observed in patients who underwent bilateral internal thoracic artery harvesting compared to those who did not.
- Decreased blood supply to the surgical site is hypothesized as a primary factor in this increased keloid risk.
Impact:
- Findings suggest modifying surgical techniques or implementing preventative strategies for patients undergoing bilateral internal thoracic artery grafting.
- Highlights the importance of considering vascular supply in sternotomy wound management to minimize adverse scarring.
- Informs clinical practice regarding patient selection and post-operative care to reduce keloid complications.
Abstract:
We discussed on the long-term anterior chest median wound keloid after the cardiac surgery by using a questionnaire. The risk of the anterior chest median wound keloid was high significantly in the cases using the bilateral internal thoracic artery compared with the cases using no internal thoracic artery. Participation of the decreased blood supply was highly suggested as the cause of this keloid formation.