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This Article Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Alert me to new issues of the journal Add to Personal Folders Download to citation manager Author home page(s): Edward B. Savage Permission Requests Citing Articles Citing Articles via Google Scholar Google Scholar Articles by Savage, E. B. Search for Related Content PubMed Articles by Savage, E. B. Related Collections Coronary disease Related Article

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Correspondence

Reply

Department of Heart and Vascular Services, St. John’s Mercy Medical Center, Suite R-7040, 625 S New Ballas Rd, St. Louis, MO 63141

(Email: ebsavage99-3{at}yahoo.com).

To the Editor:

We appreciate the comments by Drs Boodhwani and Rubens [1] regarding our article [2]. Their comments are consistent with our statements in the article. They take exception with our point regarding randomized studies of skeletonization citing two studies of skeletonization and blood flow. The first study was published by Cohen and colleagues [3], which we unfortunately missed on a literature search. The second was the study by Boodhwani and colleagues’ [4], which was published just prior to final submission of the completed text after all literature reviews had been completed. Nevertheless, it is important to emphasize that both these studies look at blood flow and offer no conclusions regarding impact on infection; consistent with our statement in the article, there is currently no randomized study showing that skeletonization reduces the incidence of perioperative infection. I look forward to seeing the results of such a study. If skeletonization can reduce infection rates, it will have an impact on practice patterns.

	References

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1. Boodhwani M, Rubens FD. Preserved sternal perfusion following ITA skeletonization: implications for bilateral ITA grafting (letter) Ann Thorac Surg 2007;84:1796-1797.[Free Full Text]
2. Savage EB, Grab JD, O’Brien SM, et al. Use of both internal thoracic arteries in diabetic patients increases deep sternal wound infection Ann Thorac Surg 2007;83:1002-1006.[Abstract/Free Full Text]
3. Cohen AJ, Lockman J, Lorberboym M, et al. Assessment of sternal vascularity with single photon emission computed tomography after harvesting of the internal thoracic artery J Thorac Cardiovasc Surg 1999;118:496-502.[Abstract/Free Full Text]
4. Boodhwani M, Lam BK, Nathan HJ, et al. Skeletonized internal thoracic artery harvest reduces pain and dysesthesia and improves sternal perfusion after coronary artery bypass surgery: a randomized, double-blind, within-patient comparison Circulation 2006;114:766-773.[Abstract/Free Full Text]

This Article Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Alert me to new issues of the journal Add to Personal Folders Download to citation manager Author home page(s): Edward B. Savage Permission Requests Citing Articles Citing Articles via Google Scholar Google Scholar Articles by Savage, E. B. Search for Related Content PubMed Articles by Savage, E. B. Related Collections Coronary disease Related Article