title: [Prophylaxis of sternal dehiscence in obese patients through systematic application of Robicsek closure].
abstract: BACKGROUND
  Sternal dehiscence is a relatively frequent complication in median sternotomy and causes high morbidity and mortality in cardiothoracic surgery. Obesity is one of the most important risk factors for sternal infection and dehiscence and its prevalence is increasingly frequent in patients undergoing cardiac surgery. The aim of the present study was to assess the clinical benefit of the prophylactic use of Robicsek sternal reinforcement in high-risk patients undergoing cardiac surgery.
  
  
  METHODS
  Two hundred ninety consecutive patients who underwent median sternotomy in our center were analyzed. The indications for prophylactic sternal reinforcement were severe sternal osteoporosis or a body mass index (BMI) of > or = 30. The technique was used in 105 patients, 54 men and 51 women, with a mean age of 67.7 +/- 9.1 years and a mean BMI of 31.8 +/- 4.1.
  
  
  RESULTS
  None of the patients in the reinforcement group developed noninfectious dehiscence; only one patient (1.7%) in this group showed sternal dehiscence due to osteomyelitis with good response to surgical debridement and intravenous antibiotics.
  
  
  CONCLUSIONS
  Robicsek reinforcement reduces the incidence of sternal dehiscence in high-risk patients and its prophylactic use should be considered in patients with severe osteoporosis or a BMI of > or = 30.
authors.affiliation: Servicio de Cirugía Cardíaca, Complejo Hospitalario de Toledo, Toledo, Spain. alfonso_c2@telefonica.net
authors.forename: Alfonso
authors.initials: A
authors.lastname: Cañas-Cañas
authors.forename: Pedro Pablo
authors.initials: PP
authors.lastname: Lima-Cañadas
authors.forename: Luis Fernando
authors.initials: LF
authors.lastname: López-Almodóvar
authors.forename: Félix
authors.initials: F
authors.lastname: Serrano-Martínez
authors.forename: Isidro
authors.initials: I
authors.lastname: Paredes-Astillero
authors.forename: María José
authors.initials: MJ
authors.lastname: Torres-Crespo
authors.forename: Manuel José
authors.initials: MJ
authors.lastname: Muñoz-Martínez
authors.forename: Antonio
authors.initials: A
authors.lastname: Pérez-Fariña
authors.forename: Jesús
authors.initials: J
authors.lastname: Porro-Hernández
authors.forename: Filadelfo
authors.initials: F
authors.lastname: Bustos-Molina
authors.forename: Manuel
authors.initials: M
authors.lastname: Calleja-Hernández
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D006348:Cardiac Surgical Procedures / Q000009:adverse effects* / Q000379:methods; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000150:complications*; D011446:Prospective Studies; D013249:Sternum / Q000601:surgery*; D013529:Surgical Wound Dehiscence / Q000517:prevention & control*; D013536:Suture Techniques