Ramzisham Abdul-Rahman Mohd, Raflis Awang Ruzairee, Khairulasri Mohd Ghani, Ooi Su Min Joanna, Fikri Abdullah Mohd, Zamrin Mohd Dimon
Division of Cardiothoracic Surgery, Heart and Lung Centre, Universiti Kebangsaan Malaysia Medical Centre, Kuala Lumpur, Malaysia.
Asian Cardiovasc Thorac Ann. 2009 Dec;17(6):587-91. doi: 10.1177/0218492309348948.
Sternal dehiscence is a rare but devastating complication following median sternotomy for cardiac surgery. The optimal technique for sternal closure is unclear. We conducted this prospective randomized trial to compare the incidence of sternal dehiscence after figure-of-8 and simple interrupted suturing in patients undergoing coronary artery bypass grafting. Between January 2007 and June 2008, 98 patients had figure-of-8 suturing and 97 had interrupted sutures. The mean age of the patients was 60.9 +/- 7.6 years. The overall sternal dehiscence rate was 8%; 7 cases in the in figure-of-8 group and 9 in the interrupted group. Thirteen patients had no wound infection and healed with conservative treatment. Only 3 patients had sternal dehiscence with infection: 2 with simple interrupted closure and 1 with figure-of-8 sternal closure. There was no significant difference in rates of sternal dehiscence between the 2 groups. It was concluded that figure-of-8 sternal suturing is equally effective as simple interrupted suturing in preventing sternal dehiscence.
胸骨裂开是心脏手术正中开胸术后一种罕见但极具破坏性的并发症。胸骨闭合的最佳技术尚不清楚。我们进行了这项前瞻性随机试验，以比较冠状动脉搭桥术患者采用8字缝合法和单纯间断缝合法后胸骨裂开的发生率。在2007年1月至2008年6月期间，98例患者采用8字缝合法，97例采用间断缝合法。患者的平均年龄为60.9±7.6岁。总体胸骨裂开率为8%；8字缝合法组有7例，间断缝合法组有9例。13例患者无伤口感染，经保守治疗愈合。仅有3例患者胸骨裂开合并感染：2例采用单纯间断缝合，1例采用8字胸骨缝合。两组之间胸骨裂开率无显著差异。得出的结论是，在预防胸骨裂开方面，8字胸骨缝合与单纯间断缝合同样有效。
