Influence of more than six sternal fixation wires on the incidence of deep sternal wound infection.
BACKGROUND
The aim of the present study was to examine the influence of the number of sternal fixation wires used on deep sternal wound infection rate and to analyze any possible interaction between this and local collagen-gentamicin prophylaxis evaluated in a previous trial.


METHODS
The number of sternal fixation wires in all patients from one of two participating centers was counted. The patients were categorized according to six or fewer (standard technique, ST group) vs. seven or more wires (extra wires, XW group).


RESULTS
The incidence of deep sternal wound infection was 4.2 % in the ST group and 0.4 % in the XW group ( P = 0.001). An analysis of the effect of local gentamicin, excluding the ST group from the analysis, showed an approximately 70 % reduction in sternal wound infection for all depths.


CONCLUSIONS
This study supports the theory that additional fixation wires at the lower sternum actually reduce the incidence of deep wound infections. We suggest that a rigid sternal fixation is required to achieve the full benefit of local collagen-gentamicin prophylaxis.
Friberg
O
O
Department of Cardiothorac Surgery and Anesthesiology, Orebro University Hospital, Orebro, Sweden. orjan.friberg@orebroll.se
Dahlin
L-G
LG
Söderquist
B
B
Källman
J
J
Svedjeholm
R
R
D000368:Aged; D019072:Antibiotic Prophylaxis; D001864:Bone Wires; D013504:Cardiovascular Surgical Procedures; D003094:Collagen / Q000627:therapeutic use; D001026:Coronary Artery Bypass; D005839:Gentamicins / Q000627:therapeutic use; D006801:Humans; D015994:Incidence; D013249:Sternum / Q000601:surgery*; D013529:Surgical Wound Dehiscence / Q000517:prevention & control; D013530:Surgical Wound Infection / Q000453:epidemiology / Q000517:prevention & control*; D013536:Suture Techniques; D013548:Sweden / Q000453:epidemiology; D013908:Thoracotomy
D005839:Gentamicins; D003094:Collagen