Off-pump coronary artery bypass grafting in a tracheostomy patient

Abstract

In patients who have undergone laryngectomy and have a tracheal stoma, a full median sternotomy substantially increases the risk of wound infection, osteomyelitis, mediastinitis, bleeding, tracheal injury, and poor wound healing. Several reports have been published on sternotomies and skin incisions in tracheostoma patients. Transverse bilateral thoracosternotomy, T-shaped partial sternotomy (manubrium-sparing sternotomy) with transverse skin flaps and anterolateral thoracotomy with partial sternotomy are described as successful approaches to the mediastinum for cardiac surgery. We present a successful case in which off-pump coronary artery bypass grafting (CABG) was performed in a tracheostoma patient using a low T-shaped partial sternotomy and the PAS-Port system. Good long-term results were achieved.

Nanozyme‐Incorporated Microneedles for the Treatment of Chronic Wounds

“…[49] Poor wound healing is also associated with poor reflux caused by venous obstruction, pressure sores from prolonged bed rest, [50] and surgical treatments such as complete median sternotomy. [51] Acute wounds undergo an inflammatory phase that lasts a few days to a few weeks, whereas chronic refractory wounds take months or years to heal. [52] High glucose levels impair both leukocyte function and dermal structure by forming advanced glycosylation end products.…”

Designing the coronary artery bypass surgery operation of the future

“…Although sternotomy does not generally constitute a very painful incision – since relatively few muscle fibers are cut – the constant respiratory movements and frequent prevalence of osteoporosis/osteopenia in cardiac surgery patients make it challenging to completely heal in each and every patient [11,12]. Attempts at limited sternotomy have been carried out through small skin incisions and T-sternotomies [13], but the main problem remains the healing of bone over a long surface, which does not fully take place in approximately 30% of patients. Consequently, many patients suffer long-term limitations or chronic pain from a sternotomy [8].…”