title: Sternal wound infections in patients undergoing open heart surgery: randomized study comparing intracutaneous and transcutaneous suture techniques.
abstract: BACKGROUND
  Intracutaneous suture technique has been our standard method for closing sternal wounds in cardiac surgery, mainly for cosmetic reasons. However, an increased rate of postoperative infections has been reported in cosmetic surgery with this method compared with the percutanous or transcutaneous closure technique. A comparison of these two techniques in cardiac surgery is presented.
  
  
  METHODS
  In a randomized study, 300 patients were selected to intracutaneous suture (n = 150) or percutanous suture (n = 150). The endpoints were superficial and deep sternal wound infections within 6 weeks postoperatively.
  
  
  RESULTS
  The total infection rate was lower in the percutanous group compared with the intracutaneous group (3% versus 8%) (p = 0.007). The superficial infection rate was lower in the percutaneous group (2.3% versus 6.7%) (p = 0.01), whereas there was no statistically significant difference in the deep infection rate between the groups.
  
  
  CONCLUSIONS
  The percutaneous suture technique reduces the incidence of superficial wound infections, but not the deep infection rate in open heart surgery. There was no difference in the cosmetic results on a visual scale, assessed by the patients.
authors.affiliation: Department of Thoracic and Cardiovascular Surgery, Rikshospitalet, Oslo, Norway. ivar.risnes@rikshospitalet.no
authors.forename: I
authors.initials: I
authors.lastname: Risnes
authors.forename: M
authors.initials: M
authors.lastname: Abdelnoor
authors.forename: S T
authors.initials: ST
authors.lastname: Baksaas
authors.forename: R
authors.initials: R
authors.lastname: Lundblad
authors.forename: J L
authors.initials: JL
authors.lastname: Svennevig
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D006348:Cardiac Surgical Procedures / Q000009:adverse effects*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012307:Risk Factors; D012867:Skin; D013249:Sternum / Q000601:surgery*; D013530:Surgical Wound Infection / Q000453:epidemiology / Q000517:prevention & control*; D013536:Suture Techniques