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William S. Stoney
William C. Alford, Jr.
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Ann Thorac Surg 1978;26:421-426
© 1978 The Society of Thoracic Surgeons

Articles

Median Sternotomy Dehiscence

William S. Stoney, M.D.*, William C. Alford, Jr., M.D., George R. Burrus, M.D., Robert A. Frist, M.D., Clarence S. Thomas, Jr., M.D.

Division of Cardiac Surgery, St. Thomas Hospital, and the Department of Cardiac and Thoracic Surgery, Vanderbilt Medical School, Nashville, TN.

* Address reprint requests to Dr. Stoney, St. Thomas Medical Building, Suite 501, 4230 Harding Rd, Nashville, TN 37205.

Sternal dehiscence requiring reoperation occurred in 36 out of 4,531 patients who had a sternotomy incision within an eight-year period. Twisted sternal wire sutures were used for the first four years and a crimped steel plate fixation was used during the second four years with a marked and significant decrease in the incidence of dehiscence from 17 out of 1,000 patients to 3 out of 1,000 patients. Thirty-five of the 36 patients were men, and 4 required reoperation for bleeding. Other factors such as mammary artery dissection, tracheostomy, and body weight of more than 82 kg were not significant. Although infection was noted in 20 patients, it was thought to be secondary. Early reoperation with antibiotic irrigation achieved wound stability in the 34 survivors with only 3 patients requiring additional procedures for chronic osteomyelitis of the sternum.




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