Clinical Outcomes of Noninfectious Sternal Dehiscence After Median Sternotomy

Olbrecht, Vanessa A.; Barreiro, Christopher J.; Bonde, Pramod; Williams, Jason A.; Baumgartner, William A.; Gott, Vincent L.; Conte, John V.

doi:10.1016/j.athoracsur.2006.04.058

Cited by 115 publications

(109 citation statements)

References 17 publications

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“…The problem of sternal resynthesis in patients with postoperative sterno- In patients with postoperative sterno-mediastinitis who developsternal dehiscence, re-osteosynthesis by standard methods (sternoraphy with metallic wire) does not achieve the solution, but contributes to further sternal fragmentation [7,4] which agrees with data of our study. Keeping this in mind, various alternative methods for sternal integrity restoration have been developed; diverse constructions with shape memory such as TiNi clips became common use.…”

Section: Discussionsupporting

confidence: 82%

“…It is characterized with high lethality rate, prolonged duration of hospitalization, necessity of repeated surgical procedures, and high cost of treatment. During recent years, there is tendency to an increase in the number of patients with postoperative sterno-mediastinitis due to growing number of thoracic surgeries [4,5,6]. The course of postoperative sterno-mediastinitis is often chronic and persistently recurrent.…”

Section: Introductionmentioning

confidence: 99%

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TiNi-based Mesh Implant Sternal Resynthesis in Patients with Postoperative Sterno-Mediastinitis

Shvedova¹,

Дамбаев²,

Vusyk³

et al. 2017

Kms

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The article presents analysis of the results of surgical treatment in patients with postoperative sterno-mediastinitis based on originally developed approach for sternal resynthesis using TiNi mesh implants compared with routine method of sternoraphy with metallic wire. The study showed that routine sternoraphy with metallic wire did not result in healing of more than a half of patients while worsening of sternal fragmentation occurred. The method of sternal resynthesis using TiNi mesh implants was developed in the Department of Hospital Surgery with Cardiovascular Surgery Courseat the SiberianStateMedicalUniversity. This method allowed to achieve good short-term results, reliable fixation of sternal fragments, and restoration of sternal integrity. However, this method is contraindicated to patients with severe sternal fragmentation. The efficacy of the proposed approach significantly exceeds that of the routine method of sternal osteosynthesis with metallic wire.

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Section: Discussionsupporting

confidence: 82%

Section: Introductionmentioning

confidence: 99%

TiNi-based Mesh Implant Sternal Resynthesis in Patients with Postoperative Sterno-Mediastinitis

Shvedova¹,

Дамбаев²,

Vusyk³

et al. 2017

Kms

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“…The use of heavy sternal wire and the figure-of-eight wiring technique was not significantly different in both groups: 9 and more vs 8 …”

Section: Resultsmentioning

confidence: 99%

“…Sternal wound complications are associated with intensive medical therapy, prolonged in-hospital stay and a high mortality rate [6]. The multitude of independent risk factors influencing the incidence of DSWI implies the complexity of the pathology [1,2,[7][8][9]. Prevention of DSWI should be focused on achieving mechanical sternal stability and preventing infection.…”

Section: Introductionmentioning

confidence: 99%

Does the number of wires used to close a sternotomy have an impact on deep sternal wound infection?

Shaikhrezai

Robertson

Anderson

et al. 2012

Interactive CardioVascular and Thoracic Surgery

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OBJECTIVES:We studied the influence of the number of sternotomy mechanical fixation points on deep sternal wound infection (DSWI). METHODS:Between September 2007 and February 2011, 2672 patients underwent a standard peri-sternal wire closure following a median sternotomy for a first-time cardiac surgery. Data were collected during the study period. RESULTS:The mean age of the patients was 66 ± 11 and 1978 (74.0%) were male. The mean body mass index (BMI) was 28.9 ± 9.3 and the median of the logistic EuroSCORE was 3.14, with a range of 0.88-54.1. Postoperatively, 40 (1.5%) patients developed DSWI after 14 ± 6 days, of whom 39 (92.5%) had positive deep sternal wound specimen cultures, predominantly Staphylococci (62.5%). The risk of DSWI was significantly increased in patients in whom eight or fewer paired points of sternal wire fixation were used when compared with patients in whom nine or more paired points of fixation were used (P = 0.002). Preoperative myocardial infarction (P = 0.001), elevated BMI (P = 0.046), bilateral internal mammary artery harvest (P < 0.0001), postoperative hypoxia (P < 0.0001), sepsis (P = 0.019) and postoperative inotrope use (P = 0.007) significantly increased the risk of DSWI.CONCLUSIONS: DSWI is associated with hypoxia, ischaemia, sepsis and mechanical sternal instability. DSWI may be prevented by using nine or more paired fixation points when closing with standard peri-sternal wires.

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“…операций на сердце [2,4]. Инфекционные осложнения со стороны передней грудной стенки после операций с трансстернальным доступом встречаются, по разным данным, в 0,3-6,9% наблюдений [5,12,20,22,24]. Лечение пациентов с септическими осложнениями остается актуальной проблемой в связи с высоким уровнем смертности, достигающим 10-47% [1, 5, 7-9, 12, 20].…”

Section: хирургия 7 2015unclassified

Surgical treatment of postoperative suppurative sternomediastinitis

IuV

et al. 2015

Khir. Z. im. N.I. Pirogova

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Clinical Outcomes of Noninfectious Sternal Dehiscence After Median Sternotomy

Cited by 115 publications

References 17 publications

TiNi-based Mesh Implant Sternal Resynthesis in Patients with Postoperative Sterno-Mediastinitis

TiNi-based Mesh Implant Sternal Resynthesis in Patients with Postoperative Sterno-Mediastinitis

Does the number of wires used to close a sternotomy have an impact on deep sternal wound infection?

Surgical treatment of postoperative suppurative sternomediastinitis

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Clinical Outcomes of Noninfectious Sternal Dehiscence After Median Sternotomy

Cited by 115 publications

References 17 publications

TiNi-based Mesh Implant Sternal Resynthesis in Patients with Postoperative Sterno-Mediastinitis

TiNi-based Mesh Implant Sternal Resynthesis in Patients with Postoperative Sterno-Mediastinitis

Does the number of wires used to close a sternotomy have an impact on deep sternal wound infection?

Surgical treatment of postoperative suppurative sterno­media­stinitis

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Surgical treatment of postoperative suppurative sternomediastinitis