The Use Of The Posthorax Sternum Stabilisation Vest Significantly Reduces Sternal Site Infections After BIMA

M Albert et Al, Robert Bosch Hospital, Stuttgart, Germany

A bilateral IMA procedure shows improved results regarding mortality, long-term survival as well as superior graft patency and thus has become the standard technique according to recent guidelines.

On the other hand, those patients might suffer from an increased risk of developing sternal wound infections, especially when being obese or having a medical history of diabetes.

One reason for the wound complications may be an early sternum instability, which could be avoided using a thorax support vest (e.g. Posthorax vest).

This retrospective study compares the wound complications after bilateral IMA grafting according to the use of a Posthorax vest.

Between April 2015 and December 2015 471 patients received a total-arterial myocardial revascularization using bilateral IMA via median sternotomy and have been administered a Posthorax support vest on 2nd postoperative day.

This group was compared to 515 patients operated via the same access the preceding 9 months. The endpoints have been the incidence of wound infections, when did the wound infection occur and how many wound revisions were needed until wound closure.

The patient demographics were similar in both groups.

Wound complications in the Posthorax group showed 0.4% compared to the Non-Vest group of 1,7%

The hospital length of stay when a wound complication occurred was 17 days with a vest and 29 days without the vest.

As seen in this retrospective study, the early perioperative use of a thorax stabilization vest such as the POSTORAX vest can reduce the incidence of sternal wound complications significantly.

When a wound infection did occur and the patients returned to hospital for wound revision, the patients who had been administered the POSTHORAX vest postoperatively had a significant shorter length of stay until wound closure.

Link to study: https://pubmed.ncbi.nlm.nih.gov/30903177/

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