title: Wound healing after harvesting of the internal thoracic and the superior and inferior epigastric arteries.
abstract: Wound healing of sternal incisions and midline or paramedian abdominal incisions was studied at 2 weeks postoperatively in three groups of dogs. Group 1, 10 dogs, had harvesting of bilateral internal thoracic arteries, superior epigastric arteries, and inferior epigastric arteries. Group 2, 5 dogs, had removal of the same arteries, but the superior and inferior epigastric arteries were harvested through paramedian rather than midline incisions. Group 3, 5 dogs, served as control and had median sternotomies and midline abdominal incisions only. All wounds healed without complication. Wound breaking strength of the skin of the chest incisions was significantly greater (p < 0.05) in the control group (group 3) (52.6 lb) compared with groups 1 (38.0 lb) and 2 (34.8 lb). Wound breaking strength of the skin of the abdominal incisions was significantly greater (p < 0.05) in group 2 (50.4 lb) when paramedian incisions were made compared with group 1 (35.1 lb). Hydroxyproline content was similar for all groups and all incisions. We conclude that abdominal wound breaking strength is significantly greater when paramedian incisions are performed to harvest the inferior epigastric arteries. Harvesting bilateral internal thoracic, superior epigastric, and inferior epigastric arteries may lower sternal wound breaking strength.
authors.affiliation: Department of Cardiothoracic Surgery, Montefiore Medical Center, Bronx, NY 10467.
authors.forename: D S
authors.initials: DS
authors.lastname: Schwartz
authors.forename: E
authors.initials: E
authors.lastname: Petrossian
authors.forename: R F
authors.initials: RF
authors.lastname: Brodman
authors.forename: R
authors.initials: R
authors.lastname: Frame
authors.forename: J D
authors.initials: JD
authors.lastname: Schwartz
authors.forename: A
authors.initials: A
authors.lastname: Blitz
authors.forename: D E
authors.initials: DE
authors.lastname: McLoughlin
authors.forename: S M
authors.initials: SM
authors.lastname: Levenson
mesh_terms: D000005:Abdomen / Q000601:surgery; D000009:Abdominal Muscles / Q000098:blood supply*; D000818:Animals; D001158:Arteries / Q000637:transplantation*; D003094:Collagen / Q000378:metabolism; D004285:Dogs; D005260:Female; D006909:Hydroxyproline / Q000378:metabolism; D012867:Skin / Q000378:metabolism / Q000503:physiopathology; D013249:Sternum / Q000601:surgery; D013718:Tensile Strength; D013895:Thoracic Arteries / Q000637:transplantation*; D014945:Wound Healing
chemical_list: D003094:Collagen; D006909:Hydroxyproline