Department of Surgery, King Abdulaziz University, Jeddah, Saudi Arabia.
aculty of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia.
Heart Surg Forum. 2020 Sep 14;23(5):E652-E657. doi: 10.1532/hsf.3153.
Sternal wound complications are significant problems in cardiac surgery and cause challenges to surgeons as they are associated with high mortality, morbidity, and a tremendous load on the hospital budget. Risk factors and preventive measures against sternal wound infection need to be in focus. Classification of different types of sternotomy complications post cardiac surgery is important for specific categorization and management. Reviewing the literature, a variety of classifications was introduced to help understand the pathophysiology of these wounds and how best to manage them. Initial classifications were based on the postoperative period of the infectious process and risk factors. Recently, the anatomical description of sternal wound, including the depth and location, was shown to be more practical. There is a lack of evidence-based surgical consensus for the appropriate management strategy, including type of closure, choice of sternal coverage post sternectomy, whether primary, delayed and when to use reconstructive flaps.
胸骨伤口并发症是心脏外科的重大问题，给外科医生带来挑战，因为它们与高死亡率、高发病率以及对医院预算的巨大负担有关。需要关注胸骨伤口感染的风险因素和预防措施。心脏手术后不同类型的胸骨切开术并发症的分类对于特定的分类和管理很重要。回顾文献，引入了多种分类方法，以帮助理解这些伤口的病理生理学，并找到最佳的处理方法。最初的分类是基于感染过程的术后阶段和风险因素。最近，胸骨伤口的解剖描述，包括深度和位置，被证明更实用。目前缺乏循证外科共识，包括适当的处理策略，包括关闭类型、胸骨切除术后胸骨覆盖的选择、是否为一期、延迟以及何时使用重建皮瓣。
