Sternum dehiscence: A preventable complication of median sternotomy

Ata, Emin Can; Beyaz, Metin Onur

Sternum dehiscence: A preventable complication of median sternotomy

dc.authorid	0000-0002-9997-9364
dc.authorid	0000-0001-9338-8152
dc.contributor.author	Ata, Emin Can
dc.contributor.author	Beyaz, Metin Onur
dc.date.accessioned	2020-10-23T06:55:23Z
dc.date.available	2020-10-23T06:55:23Z
dc.date.issued	2020
dc.department	İstanbul Medipol Üniversitesi, Tıp Fakültesi, Cerrahi Tıp Bilimleri Bölümü, Kalp ve Damar Cerrahisi Ana Bilim Dalı
dc.description.abstract	Background: The incidence of sternal dehiscence following cardiothoracic surgery via sternotomy is rare. It causes serious patient dissatisfaction and leads to higher hospital costs. For years, each clinic has made efforts to reduce this complication. Here, we aimed to summarize our techniques to prevent dehiscence.Material: This retrospective study included two groups operated via median sternotomy from March 2009 to May 2019. The first g roup included 1,105 consecutive patients who only received sternum wire for sternum closure from March 2009 to October 2013. The second group included 1,559 consecutive patients operated from January 2014 to May 2019; preventive closure techniques were performed for predefined high-risk patients in this group. These closure techniques included polyglyconate (Maxon) or simple longitudinal reinforced sutures, sternal cable or sternoband, sternal plate, and Robiscek technique.Results: All patients in Group 1, and 63.8% (995/1559) patients in Group 2 received sternal wire only (P < .001). In Group 2, we applied preventive closure techniques to 564 (36.2%) patients. There was no sternal dehiscence in Group 2, whereas 29 (2.6%) patients postoperatively suffered sternal dehiscence in Group 1; this was statistically significant (P = .001, OR:85.5, 95%CI:5.22-1400.4). The overall incidence of mediastinitis was 0.94%. The incidence significantly was lower in Group 2 (P = .004, OR:3.6, 95%CI:1.52-8.82). Sternum- related mortality in Group 2 also was lower (0.54% versus 0.06%, P = .048, OR:8.5, 95% CI: 1.02-70.75).Conclusion: Sternal dehiscence can be avoided by careful perioperative risk assessment and enhanced closure techniques. The same special consideration may significantly reduce mediastinitis and sternal-related mortality.
dc.identifier.citation	Ata, E. C. ve Beyaz, M. O. (2020). Sternum dehiscence: A preventable complication of median sternotomy. Heart Surgery Forum, 23(5), E599-E605. https://dx.doi.org/10.1532/hsf.3109
dc.identifier.doi	10.1532/hsf.3109
dc.identifier.endpage	E605
dc.identifier.issn	1098-3511
dc.identifier.issn	1522-6662
dc.identifier.issue	5
dc.identifier.scopusquality	Q3
dc.identifier.startpage	E599
dc.identifier.uri	https://dx.doi.org/10.1532/hsf.3109
dc.identifier.uri	https://hdl.handle.net/20.500.12511/5960
dc.identifier.volume	23
dc.identifier.wosquality	Q4
dc.indekslendigikaynak	Web of Science
dc.indekslendigikaynak	Scopus
dc.indekslendigikaynak	PubMed
dc.language.iso	en
dc.publisher	Forum Multimedia Publishing
dc.relation.ispartof	Heart Surgery Forum	en_US
dc.relation.publicationcategory	Makale - Uluslararası Hakemli Dergi - Kurum Öğretim Elemanı
dc.rights	info:eu-repo/semantics/openAccess
dc.subject	Median Sternotomy
dc.subject	Complication
dc.subject	Sternum Dehiscence
dc.title	Sternum dehiscence: A preventable complication of median sternotomy
dc.type	Article