2009
DOI: 10.3349/ymj.2009.50.1.78
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Abstract: PurposeBilateral in situ internal thoracic artery (ITA) bypassing may result in excellent myocardial revascularization without increasing the risk of deep sternal wound infection. Although there have been concerns with the use of pedicled bilateral ITA, the risk of infection may not be greater than the use of skeletonized ITA.Materials and MethodsThe present study was retrospectively undertaken to determine if pedicled BITA grafts are associated with a higher risk of sternal wound complications. A total of 207… Show more

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Cited by 9 publications
(9 citation statements)
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References 24 publications
(24 reference statements)
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“…This decline in wound infection rates in both diabetics and nondiabetics despite the use of pedicled BIMA suggests that attention to surgical technique, as well as attention to postoperative wound management and attempts to achieve normoglycemia, are issues that must be addressed to maximize the use of pedicled BIMA and minimize the rates of sternal wound infections. Results similar to ours have been reported by Agrifoglio et al [2008] and by Choo and associates [Choo 2009]. They attribute their low rates of sternal wound infections to the aforementioned reasons for the decline in sternal wound complications following pedicled BIMA harvest in diabetics.…”
Section: Discussionsupporting
confidence: 89%
“…This decline in wound infection rates in both diabetics and nondiabetics despite the use of pedicled BIMA suggests that attention to surgical technique, as well as attention to postoperative wound management and attempts to achieve normoglycemia, are issues that must be addressed to maximize the use of pedicled BIMA and minimize the rates of sternal wound infections. Results similar to ours have been reported by Agrifoglio et al [2008] and by Choo and associates [Choo 2009]. They attribute their low rates of sternal wound infections to the aforementioned reasons for the decline in sternal wound complications following pedicled BIMA harvest in diabetics.…”
Section: Discussionsupporting
confidence: 89%
“…In patients with mediastinitis, mortality risk factors were determined as obesity, renal failure, chronic obstructive pulmonary diseases, and advance age [Gummert 2002;El Oakley 1996;Roques 1999]. De Paulis et al suggested that bilateral pedicled harvesting of the internal thoracic arteries may carry a higher risk of sternal wound infection [De Paulis 2005], whereas Choo et al did not find a relation between bilateral internal thoracic artery harvesting and the risk of mediastinitis [Choo 2009]. But this finding hasn't reached statistical significance.…”
Section: Discussionmentioning
confidence: 99%
“…Duration of hospital stay prolongs in patients with wound infection. The vacuum-assisted closure system (VAC) serves as a suitable environment to recovery in the wound area [Fleck 2006;Roques 1999;De Paulis 2005;Choo 2009;Vos 2012;Demaria 2003]. Early recognition of sternal wound infection and aggressive treatment with reopening of the entire wound is essential to achieving a low recurrence rate [Fleck 2006].…”
Section: Introductionmentioning
confidence: 99%
“…Walkes et al [21] found a 4.4% incidence of mediastinitis when using bilateral internal mammary artery grafts, as compared with 2.2% when using single mammary artery grafts (P=0.06). A metaanalysis [22] places the use of bilateral internal thoracic artery grafts as an important risk factor for greater wound infection, but there is no consensus in the literature [23]. This fact may be explained by lower sternal and operative wound irrigation after bilateral use.…”
Section: Duringmentioning
confidence: 99%
“…Studies that have focused on the use of skeletonized internal thoracic arteries [22][23][24] have not found an increase in SWI associated with the use of bilateral internal thoracic artery grafts. In a study by Milani et al [24], in 70 diabetes patients, the use of the skeletonized bilateral internal thoracic artery significantly reduced the incidence of mediastinitis (P=0.044).…”
Section: Duringmentioning
confidence: 99%