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Feasibility of primary sternal plating for morbidly obese patients after cardiac surgery.
- Source :
-
Journal of Cardiothoracic Surgery . 1/28/2019, Vol. 14 Issue 1, p1-7. 7p. - Publication Year :
- 2019
-
Abstract
- <bold>Background: </bold>Morbidly obese patients (body mass index [BMI] ≥ 35 kg/m2) who undergo cardiac surgery involving median sternotomy have a higher-than-normal risk of sternal dehiscence. To explore a potential solution to this problem, we examined the utility of transverse sternal plating for primary sternal closure in morbidly obese cardiac surgical patients.<bold>Methods: </bold>We retrospectively reviewed data from cardiac surgical patients who underwent single primary xiphoid transverse titanium plate reinforcement for primary sternal closure from August 2009 to July 2010 (n = 8), and we compared their outcomes with those of patients with BMI ≥35 kg/m2 who underwent cardiac surgery without sternal plate reinforcement from April 2008 to July 2009 (n = 14). All cases were performed by the same surgeon.<bold>Results: </bold>The 2 groups of patients had similar demographics and comorbidities (P > 0.05 for all). All patients with sternal plate reinforcement reported sternal stability at last follow-up (at a median of 27 months postoperatively; range, 8.4-49.3 months), whereas 1 patient (7.1%) who underwent standard closure developed sterile sternal dehiscence (P = 0.4). Postoperative patient-controlled analgesia (PCA) morphine usage was significantly higher for patients without sternal plate reinforcement than for patients who had sternal plate reinforcement (3.6 mg/h vs 1.3 mg/h, P = 0.008). No patient in the sternal plate group had wound seroma or perioperative complications attributable to sternal closure technique.<bold>Conclusion: </bold>Single xiphoid transverse plate reinforcement for primary sternal closure is a feasible option for morbidly obese patients, who are otherwise at high risk of developing sternal dehiscence. Using this technique may decrease postoperative narcotics usage. Morbidly obese patients (body mass index ≥35 kg/m2) have a higher-than-normal risk of sternal dehiscence after cardiac surgery. In a pilot study, we found that those who underwent transverse sternal plating (n = 8) had no sternal dehiscence and required less postoperative analgesia than patients who underwent standard wire closure (n = 14). [ABSTRACT FROM AUTHOR]
- Subjects :
- *OVERWEIGHT persons
*CARDIAC surgery
*BODY mass index
*XIPHOID process
*ANALGESIA
*MEDIASTINITIS
*SURGICAL wound dehiscence
*THORACIC surgery
*COMPARATIVE studies
*RESEARCH methodology
*MEDICAL cooperation
*ORTHOPEDIC implants
*RESEARCH
*SUTURING
*PILOT projects
*EVALUATION research
*MORBID obesity
*RETROSPECTIVE studies
*PREVENTION
STERNUM surgery
Subjects
Details
- Language :
- English
- ISSN :
- 17498090
- Volume :
- 14
- Issue :
- 1
- Database :
- Academic Search Index
- Journal :
- Journal of Cardiothoracic Surgery
- Publication Type :
- Academic Journal
- Accession number :
- 134325058
- Full Text :
- https://doi.org/10.1186/s13019-019-0841-y