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Sternal wound dehiscence after internal mammary artery harvesting. Logical management. Part 2

Department of Surgery, Papworth Hospital, Papworth Everard, Cambridgeshire, CB3 8RE, UK

*Corresponding author: Alex Doyle, Flat 4 Number 28, Folgate Street, London, E1 6BX. Tel./fax: +44 1582 762710.

E-mail address: ajdoyle{at}gmail.com (A.J. Doyle).

Wound breakdown is a serious complication of median sternotomy. This is generally met with a further attempt at surgical apposition using sutures of monofilament surgical steel, following wound debridement. This often fails. The aim of this article is to demonstrate one surgeon's experience in his revised management of sternal wound dehiscence, following internal mammary artery (IMA) harvest, over a 7-year period. Treatment consisted of sternal and soft tissue debridement, and closed irrigation. Wound closure was performed using multiple interrupted deep tension sutures (DTS) only. We believe this article demonstrates that the use of DTS is a safe and effective method of closure, for patients suffering from sternal wound dehiscence following IMA harvest.

Key Words: IMA harvest; Sternum; Dehiscence; Closure