title: Effect of skeletonization of the internal thoracic artery for coronary revascularization on the incidence of sternal wound infection.
abstract: Use of the internal thoracic artery in coronary revascularization confers excellent benefit. We assessed the impact of skeletonization on the incidence of postoperative sternal wound infection in patients undergoing coronary artery bypass grafting. We also investigated whether there is an advantage in using this technique when harvesting both internal thoracic arteries in high-risk groups, such as diabetic patients. Skeletonization was associated with beneficial reduction in the odds ratio of sternal wound infection (odds ratio, 0.41; 95% confidence interval, 0.26 to 0.64). This effect was more evident when analyzing diabetic patients undergoing bilateral internal thoracic artery grafting (odds ratio, 0.19; 95% confidence interval, 0.10 to 0.34).
authors.affiliation: Department of Biosurgery and Surgical Technology, Imperial College London, St. Mary's Hospital, London, United Kingdom.
authors.forename: Srdjan
authors.initials: S
authors.lastname: Saso
authors.forename: David
authors.initials: D
authors.lastname: James
authors.forename: Joshua A
authors.initials: JA
authors.lastname: Vecht
authors.forename: Emaddin
authors.initials: E
authors.lastname: Kidher
authors.forename: John
authors.initials: J
authors.lastname: Kokotsakis
authors.forename: Vitali
authors.initials: V
authors.lastname: Malinovski
authors.forename: Christopher
authors.initials: C
authors.lastname: Rao
authors.forename: Ara
authors.initials: A
authors.lastname: Darzi
authors.forename: Jon R
authors.initials: JR
authors.lastname: Anderson
authors.forename: Thanos
authors.initials: T
authors.lastname: Athanasiou
mesh_terms: D000368:Aged; D003430:Cross-Sectional Studies; D006801:Humans; D015994:Incidence; D007387:Internal Mammary-Coronary Artery Anastomosis / Q000379:methods*; D008323:Mammary Arteries / Q000601:surgery*; D012307:Risk Factors; D013249:Sternum / Q000601:surgery*; D013530:Surgical Wound Infection / Q000453:epidemiology* / Q000209:etiology / Q000517:prevention & control; D020858:Tissue and Organ Harvesting / Q000379:methods*