Division of Cardiac Surgery, University of Virginia, Charlottesville, VA, USA.
Department of Cardiothoracic Surgery, Vanderbilt University, Nashville, TN, USA.
Heart Surg Forum. 2021 Mar 25;24(2):E267-E277. doi: 10.1532/hsf.3781.
While some have claimed that a median sternotomy is an 'unkind cut,' when this incision is performed, closed, and managed optimally, it can be one of the 'most kind cuts' used for major operations. The median sternotomy is the most commonly used incision for coronary artery bypass surgery, which is the most common operation performed in the United States at the current time. This approach is, of course, used for many other cardiac and thoracic operations, as well. It is, however, also one of the most misunderstood procedures in Surgery. Because it is an incision that even a novice surgical resident can perform, with proper supervision, the subtleties and nuances of not only opening but also of closing sternotomies are not often conveyed optimally to our trainees. In this treatise we will attempt to comprehensively address these subtleties, nuances, and misunderstandings, both for the benefit of our younger learners, but also, and more importantly, for the benefit of our patients.
虽然有人声称正中切开术是一种“不仁慈的切口”，但当这种切口被妥善关闭并得到最佳管理时，它可以成为用于大型手术的“最仁慈的切口”之一。正中切开术是冠状动脉旁路移植术最常用的切口，而冠状动脉旁路移植术是目前美国最常见的手术。当然，这种方法也用于许多其他心脏和胸部手术。然而，它也是外科中最被误解的手术之一。由于这是一种即使是新手外科住院医师在适当监督下也可以进行的切口，因此不仅切开，而且闭合胸骨切开术的细微之处和细微差别通常都不能很好地传达给我们的受训者。在这篇论文中，我们将尝试全面地解决这些细微差别、细微差别和误解，不仅是为了我们年轻的学习者的利益，而且更重要的是，为了我们患者的利益。
