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The Annals of Thoracic Surgery, Vol 57, 1252-1255, Copyright © 1994 by The Society of Thoracic Surgeons
DS Schwartz, E Petrossian, RF Brodman, R Frame, JD Schwartz, A Blitz, DE McLoughlin and SM Levenson
Wound healing of sternal incisions and midline or paramedian abdominal
incisions was studied at 2 weeks postoperatively in three groups of dogs.
Group 1, 10 dogs, had harvesting of bilateral internal thoracic arteries,
superior epigastric arteries, and inferior epigastric arteries. Group 2, 5
dogs, had removal of the same arteries, but the superior and inferior
epigastric arteries were harvested through paramedian rather than midline
incisions. Group 3, 5 dogs, served as control and had median sternotomies
and midline abdominal incisions only. All wounds healed without
complication. Wound breaking strength of the skin of the chest incisions
was significantly greater (p < 0.05) in the control group (group 3)
(52.6 lb) compared with groups 1 (38.0 lb) and 2 (34.8 lb). Wound breaking
strength of the skin of the abdominal incisions was significantly greater
(p < 0.05) in group 2 (50.4 lb) when paramedian incisions were made
compared with group 1 (35.1 lb). Hydroxyproline content was similar for all
groups and all incisions. We conclude that abdominal wound breaking
strength is significantly greater when paramedian incisions are performed
to harvest the inferior epigastric arteries. Harvesting bilateral internal
thoracic, superior epigastric, and inferior epigastric arteries may lower
sternal wound breaking strength.
ARTICLES
Wound healing after harvesting of the internal thoracic and the superior and inferior epigastric arteries
Department of Cardiothoracic Surgery, Montefiore Medical Center, Bronx, NY 10467.
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