ethods for Reduction of Sternal Wound

i c i m s i a p d c s d t s t w A the overall incidence of postoperative deep sternal wound infections after eart surgery continues to be low, the prevention nd subsequent management of the complication till poses a daunting task for every cardiac sureon. The reported incidence ranges from 1.3% o 5% in most recent series and with a high ssociated mortality rate of 9.8% to 14%.1-3 In ddition to the increased mortality, the condition lso carries with it a high morbidity, resulting in rolonged hospitalization and the associated inrease in cost. The average cost of hospitalization or a patient with a sternal infection is approxiately three times that of patients without ound difficulties.4 Postoperative sternal infection exists along a pectrum of presentations from sterile wound deiscence to suppurative mediastinitis, and its athogenesis is complex and multifactorial. Howver, a number of specific patient and procedure elated risk factors have been delineated.5-8 hese include obesity, diabetes, reoperation, inreased duration of the operation, coronary arery bypass grafting, use of bilateral internal thoacic arteries, postoperative inotropic support, nd the need for multiple blood transfusions. hile most of these risk factors are not amenable o intervention, others can be modified with a onsequent reduction of sternal wound complicaions. The purpose of this review is to attempt to