الفهرس | Only 14 pages are availabe for public view |
Abstract Median sternotomy is considered to be the gold standard incision for many open-heart operations including coronary artery bypass grafting (CABG).However, it is not without complications .The incidence of postoperative wound infection and morbidity ranges between 0.5% and 8%. The risk of developing post-operative mediastinitis is dependent on many factors such as off-midline sternotomy, osteoporosis, prolonged cardiopulmonary bypass, transverse fractures of the sternum, and bilateral internal mammary artery harvesting. Other risk factors for sternal dehiscence include patients’ co-morbidities (chronic obstructive pulmonary disease (COPD), renal failure, diabetes mellitus, chronic steroid use, obesity), redo operations, concurrent infection, and prolonged postoperative respiratory support. Sternal wound infections are significantly related to levels of obesity. High Body Mass Index increases the length of stay in operation room and intensive care unit (ICU) (ventilation time). The established closure technique uses steel wires in either figure 8 or simple interrupted suturing methods. In this typical technique, the steel wires are pushed across each half of sternum, however peri-sternal and pericostal placement appears to reduce sternal damage and weakening of sternal wire. Some researchers are strongly in favor of figure of 8 sternal wire closure technique and believe it to be more secure and less likely to cut the sternum, because of redistribution of shearing forces, compared to simple interrupted closure. However, disruption of a single figure-of-8 suture is equivalent to that of 2 interrupted sutures. Biomechanical studies on human cadavers and animals have assessed the efficacy of these techniques, with different results. This study aimed to compare the sternal stability, wound infection and other complications in patients undergoing CABG with steel sternal closure using figure-of-8 vs simple interrupted closure. This was a prospective randomized study carried on 60 patients presented to Menoufia University Hospitals scheduled to coronary artery bypass grafting (CABG) randomly divided into two groups, 30 patients for each group, as patients of group A: included 30 patients who was undergo figure-of-8 closure of sternum and Patients of group B: included 30 patients who was undergo simple interrupted closure of sternum during the period from March 2019 to March 2021. |