title: Do external support devices reduce sternal wound complications after cardiac surgery?
abstract: A best evidence topic in cardiac surgery was written according to a structured protocol. The question addressed was whether external support devices reduce sternal wound complications after cardiac surgery with sternotomy. Altogether 116 papers were found using the reported search, of which six presented the best evidence to answer the clinical question. The author, year, journal, study type, patient group studied, relevant outcomes, results and study weaknesses are tabulated. Six randomized controlled trials investigating the effect of external chest support devices on sternal wound complications in adult patients undergoing sternotomy for cardiac surgery were selected. These studies demonstrate a significant reduction of deep sternal wound complication on comparing external support with no support. Non-elastic devices were more effective in reducing sternal complication compared with the elastic bandage (four trials). Three studies reported significant reduction of mean hospital stay in patients receiving non-elastic chest support devices. We conclude that early post-sternotomy use of an external non-elastic sternal support device reduces overall sternal wound complications and may reduce the hospital length of stay.
authors: The University of Manchester Medical School, Manchester, UK.
authors: William
authors: W
authors: Tsang
authors: Department of Cardiac Surgery, Royal Sussex County Hospital, Brighton, UK drmodiamit@hotmail.com.
authors: Amit
authors: A
authors: Modi
authors: Department of Cardiac Surgery, Royal Sussex County Hospital, Brighton, UK.
authors: Ishtiaq
authors: I
authors: Ahmed
authors: Wessex Cardiothoracic Centre, Southampton University Hospitals, Southampton, UK.
authors: Sunil K
authors: SK
authors: Ohri
mesh_terms: D006348:Cardiac Surgical Procedures / Q000009:adverse effects*; D004867:Equipment Design; D014943:Global Health; D006801:Humans; D015994:Incidence; D056346:Sternotomy / Q000295:instrumentation*; D013249:Sternum / Q000601:surgery; D013530:Surgical Wound Infection / Q000453:epidemiology / Q000209:etiology / Q000517:prevention & control
keywords: Cardiac surgical procedures; External chest support; Postoperative complication; Review; Wound infection