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Ann Thorac Surg 2010;89:661-670. doi:10.1016/j.athoracsur.2009.08.018
© 2010 The Society of Thoracic Surgeons
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Joshua A. Vecht
Emaddin Kidher
John Kokotsakis
Vitali Malinovski
Christopher Rao
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Reviews

Effect of Skeletonization of the Internal Thoracic Artery for Coronary Revascularization on the Incidence of Sternal Wound Infection

Srdjan Saso, MBBS, BS, David James, MRCS, Joshua A. Vecht, MRCS, Emaddin Kidher, MRCS, John Kokotsakis, MD, Vitali Malinovski, MD, Christopher Rao, MBBS, Ara Darzi, KBE, HonFREng, Jon R. Anderson, FRCS(CTh), Thanos Athanasiou, MD, PhD*

Department of Biosurgery and Surgical Technology, and Surgical, Epidemiology Unit, Imperial College London, St. Mary's Hospital, London, United Kingdom

* Address correspondence to Mr Athanasiou, Department of Biosurgery and Surgical Technology, 10th Floor, QEQM Wing, St. Mary's Campus, London, W21 NY, United Kingdom (Email: t.athanasiou{at}imperial.ac.uk).

Use of the internal thoracic artery in coronary revascularization confers excellent benefit. We assessed the impact of skeletonization on the incidence of postoperative sternal wound infection in patients undergoing coronary artery bypass grafting. We also investigated whether there is an advantage in using this technique when harvesting both internal thoracic arteries in high-risk groups, such as diabetic patients. Skeletonization was associated with beneficial reduction in the odds ratio of sternal wound infection (odds ratio, 0.41; 95% confidence interval, 0.26 to 0.64). This effect was more evident when analyzing diabetic patients undergoing bilateral internal thoracic artery grafting (odds ratio, 0.19; 95% confidence interval, 0.10 to 0.34).




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