Sternal Dehiscence In Patients With Moderate and Severe Chronic Obstructive Pulmonary Disease Undergoing Cardiac Surgery
The Value of Supporting Devices to Prevent Movement of the Sternum Bone
Overview of the Study
The study aimed to investigate the incidence and effects of sternal dehiscence in patients with moderate and severe chronic obstructive pulmonary disease (COPD) who underwent cardiac surgery. The researchers also evaluated the impact of using the Robicsek technique for sternal closure and postoperative thorax support vests in reducing the occurrence of sternal dehiscence in these patients.
Methods
The study consisted of two parts. In the first part, the researchers retrospectively analyzed 842 patients who underwent cardiac surgery with figure-of-8 wire closure. These patients were divided into two groups: group 1a included 328 patients with chronic obstructive pulmonary disease, and group 1b included 514 patients without the disease.
In the second part, 221 patients with moderate and severe COPD who were scheduled for open surgery were prospectively enrolled. The researchers used the Robicsek technique for sternal closure in all patients. In group 2a, which consisted of 100 patients, a postoperative thorax support vest was also used. In contrast, no additional procedure was applied in group 2b, which included 121 patients.
Results
In the first part of the study, the incidence of sternal dehiscence was significantly higher in group 1a (7.9%) compared to group 1b (1.2%). Additionally, the mortality rates in patients with dehiscence were 53.8% in group 1a and 33.3%in group 1b.
In the second part of the study, the incidence of sternal dehiscence was significantly lower in group 2a (1%) compared to group 2b (11.5%). Notably, none of the patients with dehiscence in group 2a died, while 35.7% of patients in group 2b died.
Conclusions
Based on the findings of the study, the Robicsek technique for sternal closure and the use of postoperative thorax support vests were found to be highly effective in preventing sternal dehiscence in patients with moderate and severe chronic obstructive pulmonary disease who underwent cardiac surgery.
