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The Annals of Thoracic Surgery, Vol 49, 179-186, Copyright © 1990 by The Society of Thoracic Surgeons
FD Loop, BW Lytle, DM Cosgrove, S Mahfood, MC McHenry, M Goormastic, RW Stewart, LA Golding and PC Taylor
Of 6,504 consecutive patients who underwent isolated coronary bypass
grafting in 1985 to 1987, 72 (1.1%) patients experienced sternal wound
complications. Ten patients (14%) with wound complications died of
multi-system failure. Only the patients with negative cultures fared well;
of the bacterial culture categories, polymicrobial infection carried the
worst prognosis. Effects of recurring infection were seen throughout the
first year. Patients, grouped according to conduits received, experienced
these wound complication rates: vein grafts only, 11/1,085 (1.0%); one
internal thoracic artery, 38/4,073 (0.9%); and bilateral internal thoracic
artery grafts, 23/1,346 (1.7%). There were no significant differences in
wound complication rates between primary and reoperation patients or among
conduit groups. By logistic regression analysis, the relative risk for
patients with diabetes and bilateral internal thoracic artery grafting was
5.00 (95% confidence interval, 2.4 to 10.5). Operation time as a continuous
variable increased the relative risk of wound complication 1.47 times per
hour (1.3 to 1.7); obesity, 2.90 times (1.8 to 4.8); and blood units as
continuous variable, 1.05 times per unit (1.01 to 1.10). Bilateral internal
thoracic artery grafting in nondiabetic patients carried no greater risk of
wound complication than that in patients with vein grafts only or with one
internal thoracic artery graft.
ARTICLES
J. Maxwell Chamberlain memorial paper. Sternal wound complications after isolated coronary artery bypass grafting: early and late mortality, morbidity, and cost of care
Department of Thoracic and Cardiovascular Surgery, Cleveland Clinic Foundation, Ohio 44195-5066.
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T. J. Francel and N. T. Kouchoukos A rational approach to wound difficulties after sternotomy: the problem Ann. Thorac. Surg., October 1, 2001; 72(4): 1411 - 1418. [Abstract] [Full Text] [PDF]
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T. J. Francel and N. T. Kouchoukos A rational approach to wound difficulties after sternotomy: reconstruction and long-term results Ann. Thorac. Surg., October 1, 2001; 72(4): 1419 - 1429. [Abstract] [Full Text] [PDF]
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M. Carrier, L. P. Perrault, M. Pellerin, R. Marchand, P. Auger, G. B. Pelletier, M. White, N. Racine, and D. Bouchard Sternal wound infection after heart transplantation: incidence and results with aggressive surgical treatment Ann. Thorac. Surg., September 1, 2001; 72(3): 719 - 723. [Abstract] [Full Text] [PDF]
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J. J. Curtis, N. C. Clark, C. A. McKenney, J. T. Walls, R. A. Schmaltz, T. L. Demmy, J. W. Jones, W. R. Wilson Jr, and C. C. Wagner-Mann Tracheostomy: a risk factor for mediastinitis after cardiac operation Ann. Thorac. Surg., September 1, 2001; 72(3): 731 - 734. [Abstract] [Full Text] [PDF]
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R. Astudillo, J. Vaage, U. Myhre, A. Karevold, and B. Gardlund Fewer reoperations and shorter stay in the cardiac surgical ward when stabilising the sternum with the Ley prosthesis in post-operative mediastinitis Eur. J. Cardiothorac. Surg., July 1, 2001; 20(1): 133 - 139. [Abstract] [Full Text] [PDF]
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M. De Feo, A. Renzulli, G. Ismeno, R. Gregorio, A. Della Corte, R. Utili, and M. Cotrufo Variables predicting adverse outcome in patients with deep sternal wound infection Ann. Thorac. Surg., January 1, 2001; 71(1): 324 - 331. [Abstract] [Full Text] [PDF]
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J. H. Braxton, C. A.S. Marrin, P. D. McGrath, C. S. Ross, J. R. Morton, M. Norotsky, D. C. Charlesworth, S. J. Lahey, R. A. Clough, and G. T. O'Connor Mediastinitis and long-term survival after coronary artery bypass graft surgery Ann. Thorac. Surg., December 1, 2000; 70(6): 2004 - 2007. [Abstract] [Full Text] [PDF]
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R. Saginur, D. Croteau, and M. G. Bergeron Comparative efficacy of teicoplanin and cefazolin for cardiac operation prophylaxis in 3027 patients J. Thorac. Cardiovasc. Surg., December 1, 2000; 120(6): 1120 - 1130. [Abstract] [Full Text] [PDF]
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A. Iwakura, Y. Tabata, K. Nishimura, T. Nakamura, Y. Shimizu, M. Fujita, and M. Komeda Basic fibroblast growth factor may improve devascularized sternal healing Ann. Thorac. Surg., September 1, 2000; 70(3): 824 - 828. [Abstract] [Full Text] [PDF]
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H. F. Berg, W. G.B. Brands, T. R. van Geldorp, M. F.Q. Kluytmans-VandenBergh, and J. A.J.W. Kluytmans Comparison between closed drainage techniques for the treatment of postoperative mediastinitis Ann. Thorac. Surg., September 1, 2000; 70(3): 924 - 929. [Abstract] [Full Text] [PDF]
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C. S. Hollenbeak, D. M. Murphy, S. Koenig, R. S. Woodward, W. C. Dunagan, and V. J. Fraser The Clinical and Economic Impact of Deep Chest Surgical Site Infections Following Coronary Artery Bypass Graft Surgery Chest, August 1, 2000; 118(2): 397 - 402. [Abstract] [Full Text] [PDF]
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H. R. Zurbrugg, T. Freestone, M. Bauer, and R. Hetzer Reinforcing the conventional sternal closure Ann. Thorac. Surg., June 1, 2000; 69(6): 1957 - 1958. [Abstract] [Full Text] [PDF]
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 K. M. Detre, M. S. Lombardero, M. M. Brooks, R. M. Hardison, R. Holubkov, G. Sopko, R. L. Frye, B. R. Chaitman, and The Bypass Angioplasty Revascularization Investiga The Effect of Previous Coronary-Artery Bypass Surgery on the Prognosis of Patients with Diabetes Who Have Acute Myocardial Infarction N. Engl. J. Med., April 6, 2000; 342(14): 989 - 997. [Abstract] [Full Text] [PDF]
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H. G. Jakob, M. Borneff-Lipp, A. Bach, S. von Puckler, J. Windeler, H.-G. Sonntag, and S. Hagl The endogenous pathway is a major route for deep sternal wound infection Eur. J. Cardiothorac. Surg., February 1, 2000; 17(2): 154 - 160. [Abstract] [Full Text] [PDF]
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B. Korbmacher, H.H. Schmitt, G. Bauer, M. Hoffmann, H. Vosberg, O. Simic, and E. Gams Change of sternal perfusion following preparation of the internal thoracic artery - a scintigraphical study Eur. J. Cardiothorac. Surg., January 1, 2000; 17(1): 58 - 62. [Abstract] [Full Text] [PDF]
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W. E. Trick, W. E. Scheckler, J. I. Tokars, K. C. Jones, M. L. Reppen, E. M. Smith, and W. R. Jarvis MODIFIABLE RISK FACTORS ASSOCIATED WITH DEEP STERNAL SITE INFECTION AFTER CORONARY ARTERY BYPASS GRAFTING J. Thorac. Cardiovasc. Surg., January 1, 2000; 119(1): 108 - 114. [Abstract] [Full Text] [PDF]
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R. G. Leyh, C. Bartels, and H.-H. Sievers Adjuvant treatment of deep sternal wound infection with collagenous gentamycin Ann. Thorac. Surg., November 1, 1999; 68(5): 1648 - 1651. [Abstract] [Full Text] [PDF]
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 K. A. Eagle, R. A. Guyton, R. Davidoff, G. A. Ewy, J. Fonger, T. J. Gardner, J. P. Gott, H. C. Herrmann, R. A. Marlow, W. C. Nugent, et al. ACC/AHA guidelines for coronary artery bypass graft surgery: A report of the American College of Cardiology/ American Heart Association task force on Practice Guidelines (Committee to revise the 1991 Guidelines for Coronary Artery Bypass Graft Surgery) J. Am. Coll. Cardiol., October 1, 1999; 34(4): 1262 - 1347. [Full Text] [PDF]
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C. Y. Bitkover, K. Cederlund, B. Aberg, and J. Vaage Computed tomography of the sternum and mediastinum after median sternotomy Ann. Thorac. Surg., September 1, 1999; 68(3): 858 - 863. [Abstract] [Full Text] [PDF]
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A. J. Cohen, J. Lockman, M. Lorberboym, O. Bder, N. Cohen, B. Medalion, and A. Schachner ASSESSMENT OF STERNAL VASCULARITY WITH SINGLE PHOTON EMISSION COMPUTED TOMOGRAPHY AFTER HARVESTING OF THE INTERNAL THORACIC ARTERY J. Thorac. Cardiovasc. Surg., September 1, 1999; 118(3): 496 - 502. [Abstract] [Full Text] [PDF]
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J. Gurevitch, Y. Paz, I. Shapira, M. Matsa, A. Kramer, D. Pevni, O. Lev-Ran, Y. Moshkovitz, and R. Mohr Routine use of bilateral skeletonized internal mammary arteries for myocardial revascularization Ann. Thorac. Surg., August 1, 1999; 68(2): 406 - 411. [Abstract] [Full Text] [PDF]
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J. R. Doty, J. D. Salazar, J. D. Fonger, P. L. Walinsky, M. S. Sussman, and N. W. Salomon Reoperative MIDCAB grafting: 3-year clinical experience Eur. J. Cardiothorac. Surg., June 1, 1999; 13(6): 641 - 649. [Abstract] [Full Text] [PDF]
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C. A. Milano, G. Georgiade, L. H. Muhlbaier, P. K. Smith, and W. G. Wolfe Comparison of omental and pectoralis flaps for poststernotomy mediastinitis Ann. Thorac. Surg., February 1, 1999; 67(2): 377 - 380. [Abstract] [Full Text] [PDF]
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R. J.F. Baskett, C. E. MacDougall, and D. B. Ross Is mediastinitis a preventable complication? A 10-year review Ann. Thorac. Surg., February 1, 1999; 67(2): 462 - 465. [Abstract] [Full Text] [PDF]
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J. Bellchambers, J.M. Harris, P. Cullinan, H. Gaya, and J.R. Pepper A prospective study of wound infection in coronary artery surgery Eur. J. Cardiothorac. Surg., January 1, 1999; 15(1): 45 - 50. [Abstract] [Full Text] [PDF]
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F. D. Loop Coronary artery surgery: the end of the beginning Eur. J. Cardiothorac. Surg., December 1, 1998; 14(6): 554 - 571. [Abstract] [Full Text] [PDF]
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E. Erez, S. Eldar, E. Sharoni, D. Abramov, A. Sulkes, and B. A. Vidne Coronary artery operation in patients after breast cancer therapy Ann. Thorac. Surg., October 1, 1998; 66(4): 1312 - 1317. [Abstract] [Full Text] [PDF]
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N. J. O. Birkmeyer, D. C. Charlesworth, F. Hernandez, B. J. Leavitt, C. A. S. Marrin, J. R. Morton, E. M. Olmstead, and G. T. O'Connor Obesity and Risk of Adverse Outcomes Associated With Coronary Artery Bypass Surgery Circulation, May 5, 1998; 97(17): 1689 - 1694. [Abstract] [Full Text] [PDF]
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M. A. Borger, V. Rao, R. D. Weisel, J. Ivanov, G. Cohen, H. E. Scully, and T. E. David Deep Sternal Wound Infection: Risk Factors and Outcomes Ann. Thorac. Surg., April 1, 1998; 65(4): 1050 - 1056. [Abstract] [Full Text] [PDF]
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C. Y. Bitkover and B. Gardlund Mediastinitis After Cardiovascular Operations: A Case-Control Study of Risk Factors Ann. Thorac. Surg., January 1, 1998; 65(1): 36 - 40. [Abstract] [Full Text] [PDF]
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A. El Gamel, N. A. Yonan, R. Hassan, M. T. Jones, C. S. Campbell, A. K. Deiraniya, and R. A. M. Lawson Treatment of Mediastinitis: Early Modified Robicsek Closure and Pectoralis Major Advancement Flaps Ann. Thorac. Surg., January 1, 1998; 65(1): 41 - 46. [Abstract] [Full Text] [PDF]
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