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Todd L. Demmy
George A. Liebler
John A. Burkholder
Thomas D. Maher
Daniel H. Benckart
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George J. Magovern, Sr
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Ann Thorac Surg 1990;49:458-462
© 1990 The Society of Thoracic Surgeons

Articles

Recent experience with major sternal wound complications

Todd L. Demmy, MD, Sang B. Park, MD*, George A. Liebler, MD, John A. Burkholder, MD, Thomas D. Maher, MD, Daniel H. Benckart, MD, George J. Magovern, Jr, MD, George J. Magovern, Sr, MD

Division of Thoracic Surgery, Allegheny General Hospital, and the Allegheny Campus of Medical College of Pennsylvania, Pittsburgh, Pennsylvania USA

Accepted for publication November 20, 1989.

* Address reprint requests to Dr Park, Division of Thoracic Surgery, Allegheny General Hospital, 320 E North Ave, Pittsburgh, PA 15212.

During a recent 1-year period, 31 patients sustained a major sternal wound infection and sternal dehiscence developed in 6 patients. Multiple potential risk factors were tabulated in these patients and in a control group selected from 1,521 patients undergoing stemotomy during the same time period. The overall infection rate was 2.1%, and the mortality rate in the patients with sternal infection or dehiscence was 16.2%. Chronic obstructive pulmonary disease, prolonged intensive care unit stay, respiratory failure, connective tissue disease, and male sex were significantly higher in the group with sternal infection or dehiscence (p < 0.05). Advanced age and low cardiac output episodes were more frequent in this group, but only approached statistical significance. Although several risk factors may have been interrelated, male sex and the presence of pulmonary disease were statistically independent predictors of sternal wound infection. Risk factors may be helpful in identifying high-risk patients for additional prophylactic measures.




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