title: Sternal wrapping: developments and results.
abstract: BACKGROUND
  Postoperative sternal wound complications are infrequent events that negatively affect recovery and may have serious consequences. Sternal wrapping, a technique of sternal care, has hemostatic properties without bone wax, and offers mechanical and microbiologic protection.
  
  
  METHODS
  From February 1998 to December 2011, 258 patients in 2 Italian institutions underwent various cardiac surgery procedures with sternal wrapping in place, and were followed up for no less then 6 months.
  
  
  RESULTS
  Two (0.8%) extremely compromised patients with ischemic sternal osteonecrosis and deep sternal wound infection required a sternal stabilizing procedure. Four (2%) other patients developed sternal wound complications that were treated entirely medically; 3 of them were very trivial, and 1 was an atypical mediastinitis without sternal involvement. Overall, 46.1% of patients (45.3% of isolated coronary artery bypass, 49.3% of isolated on-pump coronary artery bypass, and 18.2% of off-pump coronary artery bypass patients) were transfused. None of the complications was related to sternal wrapping, bleeding from the sternal edge, or sternal wound problems.
  
  
  CONCLUSIONS
  Sternal wrapping showed a very low incidence and severity of sternal wound complications, with good prevention of sternal osteomyelitis. Hemostatic properties were satisfactory, with transfusion rates within an acceptable range.
authors.affiliation: Division of Cardiac Surgery, Ospedali Riuniti, Ancona, Italy.
authors.forename: Carlo
authors.initials: C
authors.lastname: Aratari
authors.forename: Filippo
authors.initials: F
authors.lastname: Capestro
authors.forename: Francesco
authors.initials: F
authors.lastname: Massi
authors.forename: Diego
authors.initials: D
authors.lastname: Magnano
authors.forename: Alexander
authors.initials: A
authors.lastname: Manché
authors.forename: Mauro
authors.initials: M
authors.lastname: Lamarra
mesh_terms: D000368:Aged; D016063:Blood Loss, Surgical / Q000517:prevention & control; D001803:Blood Transfusion; D006348:Cardiac Surgical Procedures / Q000009:adverse effects / Q000401:mortality; D005260:Female; D006489:Hemostatic Techniques / Q000009:adverse effects / Q000401:mortality; D017052:Hospital Mortality; D006801:Humans; D007558:Italy; D008297:Male; D008480:Mediastinitis / Q000517:prevention & control; D008875:Middle Aged; D010019:Osteomyelitis / Q000517:prevention & control; D011183:Postoperative Complications / Q000175:diagnosis / Q000401:mortality / Q000517:prevention & control*; D012307:Risk Factors; D056346:Sternotomy / Q000009:adverse effects / Q000401:mortality; D013530:Surgical Wound Infection / Q000517:prevention & control; D013997:Time Factors; D016896:Treatment Outcome; D014945:Wound Healing
keywords: Blood loss; cardiac surgical procedures; hemostasis; sternum; surgical; surgical wound dehiscence