TY - JOUR
T1 - Significant predictors of complications after Sternal wound reconstruction
T2 - A 21-year experience
AU - Zahiri, Hamid R.
AU - Lumpkins, Kimberly
AU - Kelishadi, Shahrooz S.
AU - Zhu, Yue
AU - Medina, Daniel
AU - Condé-Green, Alexandra
AU - Silverman, Ronald P.
AU - Slezak, Sheri
AU - Goldberg, Nelson H.
AU - Holton, Luther H.
AU - Singh, Devinder P.
PY - 2012/10/1
Y1 - 2012/10/1
N2 - BACKGROUND: We sought to identify patient comorbidities that predict complications after tissue flap sternal reconstruction. METHODS: A retrospective study, December 1989 to December 2010, analyzed numerous comorbidities, including diabetes mellitus (DM), hypertension (HTN), coronary artery disease, congestive heart failure (CHF), and renal insufficiency, as independent risk factors for postoperative complications. Pearson χ test, Fisher exact test, 2-sample t test, and median-unbiased estimation were used for data analysis. Significance was P ≤ 0.05. RESULTS: In all, 106 patients received 161 sternal tissue flap repairs. Nineteen patients (18%) required reoperation because of complications, including recurrent wound infection, tissue necrosis, wound dehiscence, mediastinitis, and hematoma formation. Our analysis found DM, HTN, and CHF as significant predictors of complications after sternal reconstruction (P = 0.014, 0.012, and 0.006). CONCLUSIONS: Results suggest DM, HTN, and CHF may contribute to complications after tissue flap repair of sternal wounds, possibly through impaired perfusion and healing of repairs.
AB - BACKGROUND: We sought to identify patient comorbidities that predict complications after tissue flap sternal reconstruction. METHODS: A retrospective study, December 1989 to December 2010, analyzed numerous comorbidities, including diabetes mellitus (DM), hypertension (HTN), coronary artery disease, congestive heart failure (CHF), and renal insufficiency, as independent risk factors for postoperative complications. Pearson χ test, Fisher exact test, 2-sample t test, and median-unbiased estimation were used for data analysis. Significance was P ≤ 0.05. RESULTS: In all, 106 patients received 161 sternal tissue flap repairs. Nineteen patients (18%) required reoperation because of complications, including recurrent wound infection, tissue necrosis, wound dehiscence, mediastinitis, and hematoma formation. Our analysis found DM, HTN, and CHF as significant predictors of complications after sternal reconstruction (P = 0.014, 0.012, and 0.006). CONCLUSIONS: Results suggest DM, HTN, and CHF may contribute to complications after tissue flap repair of sternal wounds, possibly through impaired perfusion and healing of repairs.
KW - Poststernotomy mediastinitis
KW - Sternal reconstruction
KW - Tissue flaps
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U2 - 10.1097/SAP.0b013e318231d1ef
DO - 10.1097/SAP.0b013e318231d1ef
M3 - Article
C2 - 22214795
AN - SCOPUS:84866603606
SN - 0148-7043
VL - 69
SP - 439
EP - 441
JO - Annals of plastic surgery
JF - Annals of plastic surgery
IS - 4
ER -