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Diario Oficial de la Sociedad Mexicana de Cirugía Cardiaca, A.C., y del Colegio Mexicano de Cirugía Cardiovascular y Torácica, A.C.

2017, Number 3

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Cir Card Mex 2017; 2 (3)

Experiencia de 3 años con el cierre quirúrgico esternal multitorsión

Claire-Guzman SR, Hernandez-Rendón E, López-Gutiérrez A, Alvarez-Moreno C, Salgado-Vázquez J, Riera-Kinkel C, Torres-Bernal D

Language: Spanish
References: 30
Page: 80-84
PDF size: 196.86 Kb.


ABSTRACT

Objective. To show that sternal multitwist surgical closure prevents sternal dehiscence and mediastinitis in a significant way.
Material and Methods. The present study evaluates the clinical benefit of the use of sternal multitwist surgical closure in patients factors for sternal dehiscence with risk who are operated on for cardiac surgery. Fifty-five patients undergoing cardiac surgery with risk factors for sternal dehiscence were analyzed for whom a multitorical surgical closure. All patients were followed for 14 days, 30 days and 60 postoperative days.
Results. A total of 55 patients were evaluated for multitorial closure, which presented risk factors for sternal dehiscence. Thirty-five of these patients were male and the mean age was 61.8 years. 100% with BMI greater than 30 kg/m2. The surgeries performed were myocardial revascularization in 69.1%, valvular in 23.7%, closure of ventricular septal defect in 1.8%, combined valvular and ischemic procedures in 5.4%. In 92.8%, osteoporosis occurred. None of the patients had sternal dehiscence at 2 weeks of follow-up. Mortality was 5.5%. No patient presented sternal dehiscence in 30 and 60 days. No patient had mediastinitis. The superficial infection of the sternal wound was present in 5 patients (9.1%).
Conclusions. This method of closure is effective, simple and quick to perform. It does significantly reduce the use of complex rescue techniques for failed sternal closures in patients at high risk for sternal dehiscence such as obese or osteoporotic patients.


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