Significant predictors of complications after sternal wound reconstruction: a 21-year experience.
BACKGROUND
We sought to identify patient comorbidities that predict complications after tissue flap sternal reconstruction.


METHODS
A retrospective study, December 1989 to December 2010, analyzed numerous comorbidities, including diabetes mellitus (DM), hypertension (HTN), coronary artery disease, congestive heart failure (CHF), and renal insufficiency, as independent risk factors for postoperative complications. Pearson χ2 test, Fisher exact test, 2-sample t test, and median-unbiased estimation were used for data analysis. Significance was P≤0.05.


RESULTS
In all, 106 patients received 161 sternal tissue flap repairs. Nineteen patients (18%) required reoperation because of complications, including recurrent wound infection, tissue necrosis, wound dehiscence, mediastinitis, and hematoma formation. Our analysis found DM, HTN, and CHF as significant predictors of complications after sternal reconstruction (P=0.014, 0.012, and 0.006).


CONCLUSIONS
Results suggest DM, HTN, and CHF may contribute to complications after tissue flap repair of sternal wounds, possibly through impaired perfusion and healing of repairs.
Division of General Surgery, Department of Surgery, University of Maryland School of Medicine, Baltimore, MD 21201, USA.
Hamid R
HR
Zahiri
Kimberly
K
Lumpkins
Shahrooz S
SS
Kelishadi
Yue
Y
Zhu
Daniel
D
Medina
Alexandra
A
Condé-Green
Ronald P
RP
Silverman
Sheri
S
Slezak
Nelson H
NH
Goldberg
Luther H
LH
Holton
Devinder P
DP
Singh
D048909:Diabetes Complications; D005260:Female; D006333:Heart Failure / Q000150:complications; D006801:Humans; D006973:Hypertension / Q000150:complications; D016015:Logistic Models; D008297:Male; D008480:Mediastinitis / Q000209:etiology / Q000601:surgery*; D008875:Middle Aged; D016017:Odds Ratio; D011183:Postoperative Complications / Q000453:epidemiology / Q000209:etiology* / Q000601:surgery; D019651:Plastic Surgery Procedures / Q000379:methods*; D012086:Reoperation; D012189:Retrospective Studies; D012307:Risk Factors; D056346:Sternotomy; D013524:Surgical Flaps / Q000637:transplantation*; D016896:Treatment Outcome; D058106:Wound Closure Techniques