Sternal dehiscence in patients with and without mediastinitis.

The authors compared patients with sternal dehiscence (SD) with and without mediastinitis with respect to: 1) time interval from surgery to diagnosis; and 2) frequency of sternal wire abnormalities on chest radiographs (CXR). Using a hospital information system to identify all patients with a diagnosis of SD from January 1993 through April 1999, the authors obtained clinical data by performing a retrospective chart review. For each patient, a CXR from the date of diagnosis of SD was retrospectively compared with the first postoperative CXR to assess for sternal wire displacement, rotation, and disruption. The timing of sternal wire alterations was correlated with clinical findings of SD or mediastinitis. The authors found that sternal wire abnormalities are evident radiographically in the majority of SD patients with and without mediastinitis; there is no significant difference in the frequency of sternal wire abnormalities between these two subgroups. Patients with SD and mediastinitis generally present later in the postoperative period than patients with isolated dehiscence.