Abstract: Objective To explore the causes of sternal dehiscence after coronary artery bypass grafting (CABG)，and to discuss the methods for prevention，early diagnosis，and treatments. Method 14 cases suffered sternal dehiscence after CABG in our hospital between January，2010 and June，2016 were retrospectively studied. Results Of all 14 cases,13 cases accepted resuture procedures and one case accepted conservative treatments. All patients discharged with complete wound closure. Wound healing time was (10.4±2.56)d. All patients were followed up for 3 months to 6 years after treatments, and no complications were found. Conclusion The sternal dehiscence after CABG is a rare but serious complication. The applications of proper techniques of suture, prevention and treatments of postoperative complications such as severe cough may be feasible methods to reduce the incidence of sternal dehiscence. Early sternal loosening detection and correction is the key to the treatment of sternal dehiscence and prevention of mediastinal infection.
[1] Losanoff JE, Richman BW, Jones JW.Disruption and infection of median sternotomy: a comprehensive review[J]. Eur J Cardiothorac Surg， 2002，21(5):831-839.|[2] Olbrecht VA, Barreiro CJ, Bonde PN,et al.Clinical outcomes of noninfectious sternal dehiscence after median sternotomy[J]. Ann Thorac Surg, 2006,82(3):902-907.|[3] Cicilioni OJ Jr, Stieg FH 3rd, Papanicolaou G.Sternal wound reconstruction with transverse plate fixation[J]. Plast Reconstr Surg, 2005,115(5):1297-1303.|[4] Pai S, Gunja NJ, Dupak EL, et al. A mechanical study of rigid plate configurations for sternal fixation[J]. Ann Biomed Eng, 2007,35(5):808-816.|[5] Abid Q, Podila SR, Kendall S.Sternal dehiscence after cardiac surgery and ACE inhibitors [J]. Eur J Cardiothorac Surg, 2001,20(1):203-204.|[6] 李新， 万居易， 付勇， 等. 体外循环心内直视手术后胸骨哆开保守治疗初探[J]. 四川医学,2011,32(12):1900-1902.|[7] John LC. Modified closure technique for reducing sternal dehiscence; a clinical and in vitro assessment[J]. Eur J Cardiothorac Surg, 2008,33(5):769-773. doi: 10.1016/j.ejcts.2008.01.026.|[8] 赵子牛， 程兆云， 王圣， 等. 冠状动脉搭桥术后胸骨哆开的原因分析与诊治[J]. 武汉大学学报(医学版),2012,33(6):909-911.|[9] Sahasrabudhe P, Jagtap R, Waykole P, et al. Our experience with pectoralis major flap for management of sternal dehiscence: A review of 25 cases[J]. Indian J Plast Surg, 2011,44(3):405-413. doi: 10.4103/0970-0358.90810.|[10] Lee CH, Hsien JH, Tang YB, et al. Reconstruction for sternal osteomyelitis at the lower third of sternum[J]. J Plast Reconstr Aesthet Surg, 2010 ,63(4):633-641. doi: 10.1016/j.bjps.2009.01.057.
2018, Vol. 22 
