Riess Friedrich-Christian, Awwad Nizar, Hoffmann Bettina, Bader Ralf, Helmold Hanns-York, Loewer Christine, Riess Andreas G, Bleese Niels
Department of Cardiac Surgery, Albertinen-Krankenhaus, Hamburg, Germany.
Heart Surg Forum. 2004;7(6):387-92. doi: 10.1532/HSF98.200403114.
Sternal dehiscence after full median sternotomy may result in wound-healing disorders, including osteomyelitis. The consequences are extended hospitalization, plastic surgery, stress for the patient, and increased costs. Stable closure of the median sternotomy plays a crucial role in the avoidance of sternal dehiscence and osteomyelitis.
All patients who underwent full sternotomy from January 1999 until December 2001 were investigated with respect to the incidence of sternal dehiscence. Since January 2000, patients supposed to be at risk for sternum dehiscence were more frequently treated with an Ethicon steel band at the third intercostal space in addition to standard osteosynthesis with 8 wire cerclages.
Since the introduction of this method, the incidences of sternal dehiscence and sternal wound infections decreased from 2.9% and 0.9 %, respectively, in 1999 to 0.3% and 0.2%, respectively, in 2001. This decline resulted in shorter postoperative hospital stays, less stress for the patients, and substantial reductions in postsurgical costs.
A steel band used in addition to standard osteosynthesis with 8 wire cerclages is a safe and effective procedure resulting in a statistically significant decrease in the frequency of sternal dehiscence.
全胸骨正中切开术后胸骨裂开可能导致伤口愈合障碍，包括骨髓炎。其后果是延长住院时间、进行整形手术、给患者带来压力以及增加费用。稳定闭合胸骨正中切口在避免胸骨裂开和骨髓炎方面起着关键作用。
对1999年1月至2001年12月期间接受全胸骨切开术的所有患者进行胸骨裂开发生率调查。自2000年1月起，除了采用8根钢丝环扎进行标准骨固定外，对于被认为有胸骨裂开风险的患者，更频繁地在第三肋间使用爱惜康钢带进行治疗。
自采用该方法以来，胸骨裂开和胸骨伤口感染的发生率分别从1999年的2.9%和0.9%降至2001年的0.3%和0.2%。这种下降导致术后住院时间缩短、患者压力减轻以及手术费用大幅降低。
除采用8根钢丝环扎进行标准骨固定外，使用钢带是一种安全有效的方法，可使胸骨裂开的发生率在统计学上显著降低。
