title: Figure-of-eight vs. interrupted sternal wire closure of median sternotomy.
abstract: Sternal dehiscence is a rare but devastating complication following median sternotomy for cardiac surgery. The optimal technique for sternal closure is unclear. We conducted this prospective randomized trial to compare the incidence of sternal dehiscence after figure-of-8 and simple interrupted suturing in patients undergoing coronary artery bypass grafting. Between January 2007 and June 2008, 98 patients had figure-of-8 suturing and 97 had interrupted sutures. The mean age of the patients was 60.9 +/- 7.6 years. The overall sternal dehiscence rate was 8%; 7 cases in the in figure-of-8 group and 9 in the interrupted group. Thirteen patients had no wound infection and healed with conservative treatment. Only 3 patients had sternal dehiscence with infection: 2 with simple interrupted closure and 1 with figure-of-8 sternal closure. There was no significant difference in rates of sternal dehiscence between the 2 groups. It was concluded that figure-of-8 sternal suturing is equally effective as simple interrupted suturing in preventing sternal dehiscence.
authors.affiliation: Division of Cardiothoracic Surgery, Heart and Lung Centre, Universiti Kebangsaan Malaysia Medical Centre, Kuala Lumpur, Malaysia. cardsurg2008@gmail.com
authors.forename: Abdul-Rahman Mohd
authors.initials: AR
authors.lastname: Ramzisham
authors.forename: Awang Ruzairee
authors.initials: AR
authors.lastname: Raflis
authors.forename: Mohd Ghani
authors.initials: MG
authors.lastname: Khairulasri
authors.forename: Joanna
authors.initials: J
authors.lastname: Ooi Su Min
authors.forename: Abdullah Mohd
authors.initials: AM
authors.lastname: Fikri
authors.forename: Mohd Dimon
authors.initials: MD
authors.lastname: Zamrin
mesh_terms: D000368:Aged; D001864:Bone Wires; D001026:Coronary Artery Bypass; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D011859:Radiography; D056346:Sternotomy / Q000009:adverse effects*; D013529:Surgical Wound Dehiscence / Q000000981:diagnostic imaging / Q000209:etiology / Q000517:prevention & control*; D013530:Surgical Wound Infection / Q000209:etiology / Q000517:prevention & control; D013536:Suture Techniques / Q000009:adverse effects / Q000295:instrumentation*; D013997:Time Factors; D016896:Treatment Outcome