Stoney W S, Alford W C, Burrus G R, Frist R A, Thomas C S
Ann Thorac Surg. 1978 Nov;26(5):421-6. doi: 10.1016/s0003-4975(10)62920-7.
Sternal dehiscence requiring reoperation occurred in 36 out of 4,531 patients who had a sternotomy incison within an eight-year period. Twisted sternal wire sutures were used for the first four years and a crimped steel plate fixation was used during the second four years with a marked and significant decrease in the incidence of dehiscence from 17 out of 1,000 patients to 3 out of 1,000 patients. Thirty-five of the 36 patients were men, and 4 required reoperation for bleeding. Other factors such as mammary artery dissection, tracheostomy, and body weight of more than 82 kg were not significant. Although infection was noted in 20 patients, it was thought to be secondary. Early reoperation with antibiotic irrigation achieved wound stability in the 34 survivors with only 3 patients requiring additional procedures for chronic osteomyelitis of the sternum.
在8年期间接受胸骨切开术的4531例患者中，有36例发生了需要再次手术的胸骨裂开。前4年使用扭转的胸骨钢丝缝线，后4年使用压接钢板固定，胸骨裂开的发生率从每1000例患者中的17例显著下降至每1000例患者中的3例。36例患者中有35例为男性，4例因出血需要再次手术。其他因素，如乳内动脉解剖、气管切开术和体重超过82kg，并不显著。尽管有20例患者出现感染，但认为是继发性的。早期再次手术并进行抗生素冲洗，使34名幸存者的伤口保持稳定，只有3例患者因胸骨慢性骨髓炎需要额外的治疗。
