FIGURE-OF-8 STERNAL CLOSURE VS SIMPLE INTERRUPTED STERNAL CLOSURE IN REDUCING STERNAL DEHISCENCE IN PATIENTS WITH CORONARY ARTERY BYPASS GRAFTING (CABG)

Abstract

Objective: To compare the frequency of sternal wound dehiscence in patientsundergoing CABG with figure-of-8 vs simple interrupted sternal closure.

Methodology: This randomized controlled trial consisted of patients of eithergender aged 40-70 years, undergoing elective CABG at Cardiothoracic SurgeryUnit, Punjab Institute of Cardiology, Lahore, Pakistan, from 17th July 2012 to27th August 2012 . These consented patients were randomly grouped for figureof-8 (Group A) and simple interrupted sternal wire closure (Group B).Demographical data, diabetes mellitus and smoking, cardiopulmonary bypassand cross-clamping time and postoperative sternal dehiscence were recorded.Patients were observed at 2 weeks follow up.

Result: About 200 patients with 100 in each group, were included with meanage of 52.92±7.9 years, male to female ratio of 3.4:1, mean weight of72.155±9.6 and average height of 166.72 cms, while BSA was 1.81±0.14kg/m . Diabetes Mellitus was found in 95 patients while 70 patients weresmokers. Mean CPB time was 101.035±35.7 (range 50-235 min) and crossclamp time 54.955±21.4 min. There were 10 sternal dehiscence cases: 2 inGroup A and 8 in Group B. Five patients were asymptomatic and without infection.Dehiscence was found in elderly, diabetic, overweight patients with increasedCPB and Cross clamp times. Group A had less frequency of dehiscence.

Conclusion: Applying figure of 8 sternal steel wires significantly reducedincidence of sternal wound dehiscence in CABG patients significantly.