Sternal Anomalies in Asymptomatic Patients after Median Sternotomy and Potential Influencing Factors

Biefer, Héctor Rodriguez Cetina; Sündermann, Simon H.; Alkadhi, Hatem; Genoni, Michele; Emmert, Maximilian Y.; Plass, André

doi:10.1055/s-0037-1607217

Cited by 2 publications

(2 citation statements)

References 28 publications

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“…Therefore, we used the total drainage volume, including bleeding from the sternum, as an indicator to more accurately assess the amount of bleeding from the sternum. To evaluate sternal healing, we adopted methods from previous studies [ 10 , 11 ]. Deep sternal wound infection was defined according to the following criteria: (1) bacteria could be isolated from cultures of mediastinal tissue or fluid; (2) evidence of mediastinitis was observed during surgery; and (3) presence of chest pain, sternal instability, or fever (> 38℃) with either purulent mediastinal discharge or bacterial isolation from a blood culture of drainage fluid originating from the mediastinal area [ 12 ].…”

Section: Methodsmentioning

confidence: 99%

Sternal closure with sandwiched three-piece bioresorbable mesh reduces postoperative hemorrhage: a retrospective study

Yokoyama,

Yamamoto,

Oyama

et al. 2023

J Cardiothorac Surg

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Background Median sternotomy is the most performed procedure in cardiac surgery; however, sternal displacement and bleeding remains a problem. This study aimed to investigate whether sternal reconstruction using a sandwiched three-piece bioresorbable mesh plate can prevent postoperative sternal displacement and bleeding more than a bioresorbable pin. Methods Patients (n = 218) who underwent median sternotomy were classified according to whether a sandwiched three-piece bioresorbable mesh plate and wire cerclage (group M, n = 109) or a bioresorbable pin and wire cerclage (group P, n = 109) were used during sternal reconstruction. The causes of postoperative sternal displacement and bleeding with computed tomography data were analyzed and compared between the groups. Results The preoperative patient characteristics did not significantly differ between the groups. However, the evaluation of sternal and substernal hematoma on postoperative day 5 using computed tomography showed sternal displacement in 4 (4%) and 22 (20%) patients, and substernal hematoma in 17 (16%) and 41 (38%) patients in groups M and P, respectively; this difference was significant. Furthermore, the amount of bleeding at 6 h postoperatively was lower in group M than in group P (235 ± 147 vs. 284 ± 175 mL, p = 0.0275). Chest reopening, intubation time, and length of intensive care unit and hospital stays did not differ between the groups. The evaluation of substernal hematoma based on computed tomography yielded a significantly lower for group M than for group P, revealing that the mesh plate was an independent predictor of substernal hematoma prevention. Conclusion Sternal fixation with a three-piece bioresorbable mesh plate could prevent postoperative sternal displacement, bleeding, and substernal hematoma more than sternal fixation with a pin.

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Section: Methodsmentioning

confidence: 99%

Sternal closure with sandwiched three-piece bioresorbable mesh reduces postoperative hemorrhage: a retrospective study

Yokoyama,

Yamamoto,

Oyama

et al. 2023

J Cardiothorac Surg

View full text Add to dashboard Cite

show abstract

“…3), sternal healing, and dehiscence using CT data on postoperative day. To evaluate sternal healing, we adopted methods from previous studies [10,11]. Deep sternal wound infection was de ned according to the following criteria: 1) bacteria could be isolated from cultures of mediastinal tissue or uid; 2) evidence of mediastinitis was observed during surgery; and 3) presence of chest pain, sternal instability, or fever (> 38℃) with either purulent mediastinal discharge or bacterial isolation from a blood culture of drainage uid originating from the mediastinal area [12].…”

Section: De Nitions and Endpointsmentioning

confidence: 99%

Sternal closure with sandwiched three-piece bioresorbable mesh reduces postoperative hemorrhage: a retrospective study

Yokoyama

Yamamoto

Oyama³

et al. 2023

Preprint

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Background: Median sternotomy is the most performed procedure in cardiac surgery; however, sternal bleeding remains a problem. This study aimed to investigate whether sternal reconstruction using a sandwiched three-piece bioresorbable mesh plate can prevent postoperative bleeding more than a bioresorbable pin. Methods: Patients (n = 218) who underwent median sternotomy were classified according to whether a sandwiched three-piece bioresorbable mesh plate and wire cerclage (group M, n = 109) or a bioresorbable pin and wire cerclage (group P, n = 109) was used during sternal reconstruction. The causes of postoperative bleeding and computed tomography data were analyzed and compared between the groups. Results: The preoperative patient characteristics did not significantly differ between the groups. However, the amount of bleeding at 6 h postoperatively was lower in group M than in group P (235 ± 147 vs. 284 ± 175 mL, p = 0.0275). Chest reopening, intubation time, and length of intensive care unit and hospital stays did not differ between the groups. Evaluation for sternal and substernal hematoma on postoperative day 5 using computed tomography showed sternal displacement in 4 (4%) and 22 (20%) patients, and substernal hematoma in 9 (8%) and 22 (20%) patients in groups M and P, respectively; the difference was significant. The four-grade evaluation of substernal hematoma based on computed tomography yielded a significantly lower grade for group M than for group P, revealing that the mesh plate was an independent predictor of substernal hematoma prevention. Conclusion: Sternal fixation with a three-piece bioresorbable mesh plate could prevent postoperative bleeding and substernal hematoma more than sternal fixation with a pin.

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Sternal Anomalies in Asymptomatic Patients after Median Sternotomy and Potential Influencing Factors

Cited by 2 publications

References 28 publications

Sternal closure with sandwiched three-piece bioresorbable mesh reduces postoperative hemorrhage: a retrospective study

Sternal closure with sandwiched three-piece bioresorbable mesh reduces postoperative hemorrhage: a retrospective study

Sternal closure with sandwiched three-piece bioresorbable mesh reduces postoperative hemorrhage: a retrospective study

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