HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to Personal Folders Download to citation manager Author home page(s): Giulio Rizzoli Dino Casarotto Gino Gerosa Permission Requests Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Bottio, T. Articles by Gerosa, G. Search for Related Content PubMed PubMed Citation Articles by Bottio, T. Articles by Gerosa, G. Related Collections Cardiac - other

J Thorac Cardiovasc Surg 2003;126:1352-1356
© 2003 The American Association for Thoracic Surgery

Surgery for acquired cardiovascular disease

Double crisscross sternal wiring and chest wound infections: A prospective randomized study

^a Department of Cardiovascular Surgery, University of Padua Medical School, Padua, Italy

Received for publication April 8, 2003; revisions received May 12, 2003; revisions received May 27, 2003; accepted for publication June 9, 2003.

^* Address for reprints: Tomaso Bottio, MD, Istituto di Cardiochirurgia, Università di Padova, Via Giustiniani 2, Padova, Italy
tomaso.bottio{at}unipd.it

OBJECTIVE: We sought to assess the efficiency of 2 different sternal wiring techniques in preventing deep sternal wound infection or sternal instability.

METHODS: Seven hundred patients were randomized to 2 different groups according to chest-closure techniques. Three hundred fifty patients who underwent a peristernal double crisscross wire closure were included in group X, whereas 350 patients who underwent a standard transsternal closure were included in group T. After sternal closure, the technique for wound suturing was the same for both groups, namely triple-layer sutures up to the intracutaneous skin. All data were prospectively collected and entered in our institute database.

RESULTS: The 2 groups of patients were comparable for sex, age, preoperative risk factors, and operative procedures. The overall mortality rate was 4.3% in group X and 4.6% in group T. Postoperative morbidity and mortality were comparable between the 2 groups, unlike for sternal wound complications. None of the patients included in group X had superficial or deep wound complications, whereas in group T 7 (2%) patients presented with a superficial sternal wound infection, 6 (1.7%) presented with a deep chest wound infection with sternal instability requiring re-exploration (P < .05), and 3 presented with a sternal instability caused by sternum disruption without infection. Among patients with deep wound infection and sternal instability, 1 patient died, resulting in a mortality rate of 16.7%.

CONCLUSIONS: The peristernal double crisscross wiring technique achieved a greater sternal stability, resulting in a lower incidence of wound infection in association with triple-layer closure of suprasternal tissues.

This article has been cited by other articles:

				C. Schimmer, W. Reents, S. Berneder, P. Eigel, O. Sezer, H. Scheld, K. Sahraoui, B. Gansera, O. Deppert, A. Rubio, et al. Prevention of Sternal Dehiscence and Infection in High-Risk Patients: A Prospective Randomized Multicenter Trial Ann. Thorac. Surg., December 1, 2008; 86(6): 1897 - 1904. [Abstract] [Full Text] [PDF]

				C. Schimmer, S.-P. Sommer, M. Bensch, T. Bohrer, I. Aleksic, and R. Leyh Sternal closure techniques and postoperative sternal wound complications in elderly patients. Eur. J. Cardiothorac. Surg., July 1, 2008; 34(1): 132 - 138. [Abstract] [Full Text] [PDF]

				L. C.H. John Modified closure technique for reducing sternal dehiscence; a clinical and in vitro assessment Eur. J. Cardiothorac. Surg., May 1, 2008; 33(5): 769 - 773. [Abstract] [Full Text] [PDF]

				T. Bottio, V. Tarzia, and C. Muneretto Parasternal Wire Technique and Sternal Dehiscence Ann. Thorac. Surg., March 1, 2005; 79(3): 1096 - 1097. [Full Text] [PDF]