Prevention of Sternal Wound Infections in Women Using an External Sternum Fixation Corset

Ann Thorac Cardiovasc Surg. 2021 Feb 20;27(1):25-31. doi: 10.5761/atcs.oa.19-00293. Epub 2020 Jul 2.

Abstract

Purpose: Deep sternal wound infection (DSWI) and mediastinitis are devastating complications after median sternotomy. Previous studies demonstrated an effective prevention of sternal wound infection (SWI) using an external sternal corset in high-risk cardiac surgery patients. The aim of this study is to assess the preventive effect of the Stern-E-Fix corset in high-risk poststernotomy female patients.

Methods: A total of 145 high-risk female patients undergoing cardiac surgery through median sternotomy were retrospectively analyzed. Patients were divided into group A (n = 71), who received the Stern-E-Fix corset (Fendel & Keuchen GmbH, Aachen, Germany), and group B (n = 74), who received the elastic thorax bandage (SanThorax) postoperatively for 6 weeks. The mean follow-up period was 12 weeks.

Results: Incidence of SWI was 7% in group A vs. 17.6% in group B (p = 0.025). One patient presented with DSWI in group A vs. seven patients in group B (p = 0.063). No patient developed mediastinitis in group A vs. four patients in group B (p = 0.121). In all, 4.2% of group A patients required operative wound therapy vs. 16.2% of group B patients (p = 0.026). The length of hospital stay was significantly longer in group B (p = 0.006).

Conclusion: Using an external supportive sternal corset (Stern-E-Fix) yields a significantly better and effective prevention against development of sternal dehiscence, DSWI, and mediastinitis in high-risk poststernotomy female patients.

Keywords: Stern-E-Fix corset; external sternal corset; mediastinitis; sternal dehiscence; sternal wound infection.

MeSH terms

  • Aged
  • Aged, 80 and over
  • Braces*
  • Cardiac Surgical Procedures / adverse effects*
  • Equipment Design
  • Female
  • Humans
  • Length of Stay
  • Mediastinitis / diagnosis
  • Mediastinitis / microbiology
  • Mediastinitis / prevention & control*
  • Middle Aged
  • Retrospective Studies
  • Risk Factors
  • Sternotomy / adverse effects*
  • Surgical Wound Dehiscence / diagnosis
  • Surgical Wound Dehiscence / prevention & control*
  • Surgical Wound Infection / diagnosis
  • Surgical Wound Infection / microbiology
  • Surgical Wound Infection / prevention & control*
  • Time Factors
  • Treatment Outcome
  • Wound Closure Techniques / adverse effects
  • Wound Closure Techniques / instrumentation*