Outcome of primary chest packing and delayed sternal closure for intractable bleeding following heart surgery.

Post-operative bleeding is a life-threatening complication encountered following cardiac surgery. In cases where bleeding cannot be controlled by correcting clotting derangements and using standard surgical techniques, packing the chest may be an important salvation method. The aim was to determine the outcome of patients having primary chest packing in theatre for intractable bleeding following heart surgery. The method used was retrospective analysis of patients' medical records. Over a 9-year period, 6890 patients had open-heart surgery at the Manchester Royal Infirmary. Twenty (0.29%) of these patients had their chests packed prior to leaving theatre, 19 for uncontrolled bleeding, and one for inaccessible bleeding. Five (25%) of these patients required one further packing. The majority of patients (85%) survived. None developed a sternal wound infection. The conclusion drawn was that chest packing could be a life-saving procedure following heart surgery.