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Ann Thorac Surg 2001;72:1587-1591
© 2001 The Society of Thoracic Surgeons
a Department of Thoracic and Cardiovascular Surgery, Rikshospitalet, Oslo, Norway
Accepted for publication July 10, 2001.
* Address reprint requests to Dr Risnes, Department of Thoracic and Cardiovascular Surgery, Rikshospitalet, N-0027 Oslo, Norway
e-mail: ivar.risnes{at}rikshospitalet.no
Background. Intracutaneous suture technique has been our standard method for closing sternal wounds in cardiac surgery, mainly for cosmetic reasons. However, an increased rate of postoperative infections has been reported in cosmetic surgery with this method compared with the percutanous or transcutaneous closure technique. A comparison of these two techniques in cardiac surgery is presented.
Methods. In a randomized study, 300 patients were selected to intracutaneous suture (n = 150) or percutanous suture (n = 150). The endpoints were superficial and deep sternal wound infections within 6 weeks postoperatively.
Results. The total infection rate was lower in the percutanous group compared with the intracutaneous group (3% versus 8%) (p = 0.007). The superficial infection rate was lower in the percutaneous group (2.3% versus 6.7%) (p = 0.01), whereas there was no statistically significant difference in the deep infection rate between the groups.
Conclusions. The percutaneous suture technique reduces the incidence of superficial wound infections, but not the deep infection rate in open heart surgery. There was no difference in the cosmetic results on a visual scale, assessed by the patients.
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