Sternal wrapping: developments and results

Asian Cardiovasc Thorac Ann. 2013 Jun;21(3):319-25. doi: 10.1177/0218492312458595.

Abstract

Background: Postoperative sternal wound complications are infrequent events that negatively affect recovery and may have serious consequences. Sternal wrapping, a technique of sternal care, has hemostatic properties without bone wax, and offers mechanical and microbiologic protection.

Methods: From February 1998 to December 2011, 258 patients in 2 Italian institutions underwent various cardiac surgery procedures with sternal wrapping in place, and were followed up for no less then 6 months.

Results: Two (0.8%) extremely compromised patients with ischemic sternal osteonecrosis and deep sternal wound infection required a sternal stabilizing procedure. Four (2%) other patients developed sternal wound complications that were treated entirely medically; 3 of them were very trivial, and 1 was an atypical mediastinitis without sternal involvement. Overall, 46.1% of patients (45.3% of isolated coronary artery bypass, 49.3% of isolated on-pump coronary artery bypass, and 18.2% of off-pump coronary artery bypass patients) were transfused. None of the complications was related to sternal wrapping, bleeding from the sternal edge, or sternal wound problems.

Conclusions: Sternal wrapping showed a very low incidence and severity of sternal wound complications, with good prevention of sternal osteomyelitis. Hemostatic properties were satisfactory, with transfusion rates within an acceptable range.

Keywords: Blood loss; cardiac surgical procedures; hemostasis; sternum; surgical; surgical wound dehiscence.

Publication types

  • Case Reports
  • Multicenter Study

MeSH terms

  • Aged
  • Blood Loss, Surgical / prevention & control
  • Blood Transfusion
  • Cardiac Surgical Procedures* / adverse effects
  • Cardiac Surgical Procedures* / mortality
  • Female
  • Hemostatic Techniques* / adverse effects
  • Hemostatic Techniques* / mortality
  • Hospital Mortality
  • Humans
  • Italy
  • Male
  • Mediastinitis / prevention & control
  • Middle Aged
  • Osteomyelitis / prevention & control
  • Postoperative Complications / diagnosis
  • Postoperative Complications / mortality
  • Postoperative Complications / prevention & control*
  • Risk Factors
  • Sternotomy* / adverse effects
  • Sternotomy* / mortality
  • Surgical Wound Infection / prevention & control
  • Time Factors
  • Treatment Outcome
  • Wound Healing*