Department of Cardiovascular Surgery, Kochi Medical School, Kochi, Japan.
Liaison Healthcare Engineering Section, Kochi Medical School, Kochi, Japan.
J Int Med Res. 2024 Oct;52(10):3000605241281915. doi: 10.1177/03000605241281915.
Median sternotomy is a standard approach in cardiovascular surgery, and wire fixation is commonly used for sternal closure. However, postoperative intermittent stress on the sternum can lead to sternal breakdown, potentially resulting in deep sternal wound infection (DSWI). Sternal closure with rigid plate fixation was recently reported to be effective for preventing DSWI and promoting sternal healing. We investigated the effectiveness of a rigid plate fixation system in patients at a high risk of developing DSWI.
This retrospective observational study evaluated the incidence of DSWI and the progression of postoperative sternal fusion observed on computed tomography. Forty-eight patients at a high risk of DSWI who underwent sternal closure with a rigid plate fixation system between 2020 and 2023 were assessed.
Among the 48 patients, 1 (2.1%) developed DSWI requiring surgical treatment. Sternal fusion improved over time, with significant progression observed during the follow-up period compared with the early postoperative period. Additionally, patients who did not show sternal fusion in the early postoperative period showed progressive fusion during follow-up.
The rigid plate fixation system prevents sternal displacement and may be beneficial in preventing DSWI by maintaining and promoting sternal fusion in high-risk patients.
正中开胸术是心血管外科的标准入路，钢丝固定常用于胸骨关闭。然而，胸骨的间歇性术后应力会导致胸骨破裂，可能导致深部胸骨伤口感染（DSWI）。最近有报道称，使用刚性板固定系统预防 DSWI 和促进胸骨愈合的效果良好。我们研究了刚性板固定系统在发生 DSWI 风险较高的患者中的有效性。
本回顾性观察研究评估了 DSWI 的发生率和术后 CT 观察到的胸骨融合进展情况。2020 年至 2023 年间，我们评估了 48 例因 DSWI 高风险而行刚性板固定系统胸骨闭合的患者。
在 48 例患者中，1 例（2.1%）发生需要手术治疗的 DSWI。胸骨融合随时间推移而改善，与术后早期相比，随访期间观察到明显进展。此外，在术后早期未显示胸骨融合的患者在随访期间显示出逐渐融合。
刚性板固定系统可防止胸骨移位，并通过维持和促进高危患者的胸骨融合，可能有益于预防 DSWI。
