Anger Jaime, Dantas Daniel Chagas, Arnoni Renato Tambellini, Farsky Pedro Sílvio
Dante Pazzanese Institute of Cardiology of São Paulo, São Paulo, SP, Brazil.
Rev Bras Cir Cardiovasc. 2015 Jan-Mar;30(1):114-8. doi: 10.5935/1678-9741.20140033.
The dehiscence after median transesternal sternotomy used as surgical access for cardiac surgery is one of its complications and it increases the patient's morbidity and mortality. A variety of surgical techniques were recently described resulting to the need of a classification bringing a measure of objectivity to the management of these complex and dangerous wounds. The different related classifications are based in the primary causal infection, but recently the anatomical description of the wound including the deepness and the vertical extension showed to be more useful. We propose a new classification based only on the anatomical changes following sternotomy dehiscence and chronic wound formation separating it in four types according to the deepness and in two sub-groups according to the vertical extension based on the inferior insertion of the pectoralis major muscle.
经胸骨正中劈开术作为心脏手术的手术入路后发生的胸骨裂开是其并发症之一，会增加患者的发病率和死亡率。最近描述了多种手术技术，因此需要一种分类方法，以便在处理这些复杂且危险的伤口时具有一定的客观性。不同的相关分类基于原发性感染原因，但最近对伤口的解剖学描述，包括深度和垂直延伸，显示出更有用。我们提出一种仅基于胸骨裂开和慢性伤口形成后的解剖学变化的新分类方法，根据深度将其分为四种类型，并根据胸大肌的下部附着点，按垂直延伸分为两个亚组。
