scholarly journals Sternal wound infections and internal mammary artery grafts

1993 ◽  
Vol 106 (1) ◽  
pp. 181-182 ◽  
Author(s):  
A.G. Jayakrishnan ◽  
A. Allan ◽  
A.T. Forsyth ◽  
J.B. Desai
Keyword(s):  
Internal Mammary Artery ◽  
Wound Infections ◽  
Internal Mammary ◽  
Sternal Wound Infections

scholarly journals 177 Pedicled Or Skeletonized Bilateral Internal Mammary Artery Harvesting - A Meta- Analysis and Trial Sequential Analysis

2021 ◽  
Vol 108 (Supplement_6) ◽  
Author(s):  
S Iddawela ◽  
S L Mellor ◽  
S A Zahra ◽  
Y Khare ◽  
A Harky
Keyword(s):  
Sequential Analysis ◽  
Internal Mammary Artery ◽  
Meta Analysis ◽  
Artery Bypass ◽  
Trial Sequential Analysis ◽  
Wound Infections ◽  
Cochrane Database ◽  
Internal Mammary ◽  
Risk Patients ◽  
Sternal Wound Infections

Abstract Objective There is varying evidence on the role of skeletonization of internal mammary artery in reducing the risk of sternal wound infections and ischemia following bilateral internal mammary artery grafting. We opt to compare post-operative clinical outcomes of skeletonized bilateral internal mammary artery versus pedicled bilateral internal mammary artery harvesting in patients undergoing coronary artery bypass surgery. Method A comprehensive electronic search was conducted using PubMed/MEDLINE, Scopus, EMBASE, Cochrane database and Google Scholar from inception until 15th June 2020. All studies directly comparing skeletonized and pedicled bilateral internal mammary artery harvesting were included. Meta-analysis and trial sequential analysis was conducted. Results Ten studies consisting of 3728 patients (2098 patients with skeletonized bilateral internal mammary artery grafting and 1630 patients with pedicled bilateral internal mammary artery grafting) were included. Pooled effects analysis and trial sequential analysis reported significantly lower risk of sternal wound infection with skeletonized bilateral internal mammary artery harvesting (OR 0.32, 95% CI 0.20 – 0.51, p < 0.00001). S-BIMA may be associated with lower late mortality, but more information is required to confirm this. Conclusions Skeletonization reduces the risk of sternal wound infections by preserving vasculature as much as possible. This makes it an important technique for use in bilateral internal mammary artery grafting for high-risk patients.

scholarly journals Sternal wound infections and internal mammary artery grafts: Reply to the Editor

1993 ◽  
Vol 106 (1) ◽  
pp. 182
Author(s):  
Eugene A. Grossi ◽  
Rick A. Esposito ◽  
Aubrey Galloway ◽  
Gregory Baumann
Keyword(s):  
Internal Mammary Artery ◽  
Wound Infections ◽  
Internal Mammary ◽  
Sternal Wound Infections

scholarly journals Sternal wound infections and use of internal mammary artery grafts

1991 ◽  
Vol 102 (3) ◽  
pp. 342-347 ◽  
Author(s):  
Eugene A. Grossi ◽  
R. Esposito ◽  
L.J. Harris ◽  
G.A. Crooke ◽  
A.C. Galloway ◽  
...  
Keyword(s):  
Internal Mammary Artery ◽  
Wound Infections ◽  
Internal Mammary ◽  
Sternal Wound Infections

scholarly journals Total arterial myocardial revascularization using bilateral internal mammary arteries and the role of postoperative sternal stabilization to reduce wound infections in a large cohort study

2019 ◽  
Vol 29 (2) ◽  
pp. 224-229 ◽  
Author(s):  
Marc Albert ◽  
Ragi Nagib ◽  
Adrian Ursulescu ◽  
Ulrich F W Franke
Keyword(s):  
Retrospective Study ◽  
Wound Infection ◽  
Internal Mammary Artery ◽  
Wound Closure ◽  
Myocardial Revascularization ◽  
Wound Complications ◽  
Wound Infections ◽  
Term Survival ◽  
Mammary Arteries ◽  
Internal Mammary

Abstract OBJECTIVES Total arterial myocardial revascularization using bilateral internal mammary arteries shows improved results for mortality, long-term survival and superior graft patency. It has become the standard technique according to recent guidelines. However, these patients may have an increased risk of developing sternal wound infections, especially obese patients or those with diabetes. One reason for the wound complications may be early sternum instability. This situation could be avoided by using a thorax support vest (e.g. Posthorax® vest). This retrospective study compared the wound complications after bilateral internal mammary artery grafting including the use of a Posthorax vest. METHODS Between April 2015 and May 2017, 1613 patients received total arterial myocardial revascularization using bilateral internal mammary artery via a median sternotomy. The Posthorax support vest was used from the second postoperative day. We compared those patients with 1667 patients operated on via the same access in the preceding 26 months. The end points were the incidence of wound infections, when the wound infection occurred and how many wound revisions were needed until wound closure. RESULTS The demographic data of both groups were similar. A significant advantage for the use of a thorax support vest could be seen regarding the incidence of wound infections (P = 0.036) and the length of hospital stay when a wound complication did occur (P = 0.018). CONCLUSIONS As seen in this retrospective study, the early perioperative use of a thorax stabilization vest, such as the Posthorax vest, can reduce the incidence of sternal wound complications significantly. Furthermore, when a wound infection occurred, and the patient returned to the hospital for wound revision, patients who were given the Posthorax vest postoperatively had a significantly shorter length of stay until wound closure.

Sternal Wound Infections

1993 ◽  
Vol 4 (3) ◽  
pp. 475-483
Author(s):  
Patricia L. Vaska
Keyword(s):  
Heart Surgery ◽  
Artery Bypass ◽  
Open Heart Surgery ◽  
Signs And Symptoms ◽  
Diabetic Patients ◽  
Wound Infections ◽  
Great Vessels ◽  
Internal Mammary ◽  
The Common ◽  
Sternal Wound Infections

Sternal wound infections are a major cause of morbidity and mortality in patients undergoing cardiac surgery. They occur in 1% to 3% of patients who undergo open-heart surgery and carry a 20% to 40% mortality rate. Sternal infections can range from minor, superficial infections to open mediastinitis with invasion of the sternum, heart, and great vessels. Staphylococcus species arc responsible for the majority of sternal infections, but environmental sources can cause infections by other organisms. The common signs and symptoms of mediastinitis are fever, leukocytosis, sternal instability, drainage, and pain. Several risk factors exist for sternal wound infection, with bilateral internal mammary artery bypass grafting in diabetic patients being the most common. Treatment entails surgical debridement with cither closed irrigation, open-wound packing, or muscle or omental flap procedures, as well as antibiotic therapy. Some simple procedures help limit the development of sternal infections in certain patients

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