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Comparison of Sternal Wound Complication after Off-Pump CABG between Skeletonized and Pedicled LIMA Harvesting: A Single Centre Experience in Bangladesh

DOI: 10.4236/wjcs.2023.136010, PP. 101-110

Keywords: Sternal Wound Complication (SWC), Off-Pump Coronary Artery Bypass Grafting (OPCAB), Left Internal Mammary Artery (LIMA), Skeletonized LIMA Harvesting, Pedicle LIMA Harvesting

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Abstract:

Background: Off-pump coronary artery bypass grafting (OPCAB) is a surgical procedure that has gained popularity due to its potential benefits over traditional coronary artery bypass grafting, including reduced morbidity and mortality. However, sternal wound complication (SWC) remains challenging following the procedure. The technique of left internal mammary artery (LIMA) harvesting has been shown to impact the incidence of SWC. This study aimed to compare the incidence of SWC between two techniques of LIMA harvesting, i.e., skeletonized and pedicled. Methods: The study was conducted at the Department of Cardiac Surgery, Bangabandhu Sheikh Mujib Medical University, and included 60 patients who underwent OPCAB. The patients were divided into two groups of 30 each based on the technique of LIMA harvesting used, i.e., skeletonized (group A) or pedicled (group B). The postoperative ICU care was given to each patient as per the protocol. The statistical analysis was conducted using the SPSS version 26.0 for Windows software. Results: The results showed that 5 (8.33%) patients developed SWC, with 1 (1.67%) patient in group A and 4 (6.66%) patients in group B. However, the occurrence of SWC was not statistically significant between the two groups (p = 0.35). The mean age, gender distribution, and comorbidities such as hypertension, diabetes, dyslipidemia, and anemia were also not statistically significant between the two groups. The number of smokers was statistically significant between the two groups (p

References

[1]  Shroyer, A.L., Grover, F.L., Hattler, B., Collins, J.F., McDonald, G.O., Kozora, E., Lucke, J.C., Baltz, J.H. and Novitzky, D. (2012) On-Pump versus Off-Pump Coronary Artery Bypass Surgery. The New England Journal of Medicine, 361, 1827-1837.
https://doi.org/10.1056/NEJMoa0902905
[2]  Rehman, H., Samad, Z., Mishra, S.R., Merchant, A.T., Narula, J.P., Mishra, S. and Virani, S.S. (2018) Epidemiologic Studies Targeting Primary Cardiovascular Disease Prevention in South Asia. Indian Heart Journal, 70, 721-730.
https://doi.org/10.1016/j.ihj.2018.01.029
[3]  Onorati, F., Esposito, A., Pezzo, F., di Virgilio, A., Mastroroberto, P. and Renzulli, A. (2007) Hospital Outcome Analysis after Different Techniques of Left Internal Mammary Grafts Harvesting. The Annals of Thoracic Surgery, 86, 1912-1919.
https://doi.org/10.1016/j.athoracsur.2007.06.024
[4]  Tector, A.J., Kress, D.C., Downey, F.X. and Schmahl, T.M. (1996) Complete Revascularization with Internal Thoracic Artery Grafts. Seminars in Thoracic and Cardiovascular Surgery, 8, 29-46.
[5]  Takami, Y. and Ina, H. (2002) Effects of skeletonization on intraoperative flow and anastomosis diameter of internal thoracic arteries in coronary artery bypass grafting. The Annals of Thoracic Surgery. Vol.73, pp.1441-1445.
https://doi.org/10.1016/S0003-4975(02)03501-4
[6]  Mailis, A., Umana, M. and Feindel, C.M., (2000). Anterior Intercostal Nerve Damage after Coronary Artery Bypass Graft Surgery with Use of Internal Thoracic Artery Graft. The Annals of Thoracic Surgery, 69, 1455-1458.
https://doi.org/10.1016/S0003-4975(00)01186-3
[7]  Berdajs, D., Zünd, G., Turina, M.I. and Genoni, M. (2006) Blood Supply of the Sternum and Its Importance in Internal Thoracic Artery Harvesting. The Annals of Thoracic Surgery, 81, 2155-2159.
https://doi.org/10.1016/j.athoracsur.2006.01.020
[8]  Cohen, A.J., Lockman, J., Lorberboym, M., Bder, O., Cohen, N., Medalion, B. and Schachner, A. (1999) Assessment of Sternal Vascularity with Single Photon Emission Tomography after Harvesting of the Internal Thoracic Artery. The Journal of Thoracic and Cardiovascular Surgery, 118, 496-502.
https://doi.org/10.1016/S0022-5223(99)70188-1
[9]  Gupta, A., Hote, M.P., Choudhury, M., Kapil, A. and Bisoi, A.K. (2010) Comparison of 48h and 72h of Prophylactic Antibiotic Therapy in Adult Cardiac Surgery: A Randomized Double Blind Controlled Trial. Journal of Antimicrobial Chemotherapy, 65, 1036-1041.
https://doi.org/10.1093/jac/dkq080
[10]  El Oakley, R.M. and Wright, J.E. (1996) Postoperative Mediastinitis: Classification and Management. The Annals of Thoracic Surgery, 61, 1030-1036.
https://doi.org/10.1016/0003-4975(95)01035-1
[11]  Kouchoukos, N.T., Blackstone, E.H., Hanley, F.L. and Kirklin, J.K. (2013) Kirklin/Barratt-Boyes Cardiac Surgery. 4th Edition, Elsevier Saunders, Philadelphia.
[12]  Peterson, M.D., Borger, M.A., Rao, V., Peniston, C.M. and Feindel, C.M. (2003) Skeletonization of Bilateral Internal Thoracic Artery Grafts Lowers the Risk of Sternal Complication in Patients with Diabetes. The Journal of Thoracic and Cardiovascular Surgery, 126, 1314-1319.
https://doi.org/10.1016/S0022-5223(03)00808-0
[13]  Furnary, A.P., Zerr, K.J., Grunkemeier, G.L. and Starr, A. (1999) Continuous Intravenous Insulin Infusion Reduces the Incidence of Deep Sternal Wound Infection in Diabetic Patients after Cardiac Surgical Procedures. The Annals of Thoracic Surgery, 67, 352-360.
https://doi.org/10.1016/S0003-4975(99)00014-4
[14]  Chen, L.F., Arduino, J.M., Sheng, S., Muhlbaier, L.H., Kanafani, Z.A., Harris, A.D., Fraser, T.G., Allen, K., Corey, G.R. and Fowler Jr., V.G. (2012) Epidemiology and Outcome of Major Postoperative Infections following Cardiac Surgery: Risk Factors and Impact of Pathogen Type. American Journal of Infection Control, 40, 963-968.
https://doi.org/10.1016/j.ajic.2012.01.012
[15]  Lola, I., Levidiotou, S., Petrou, A., Arnaoutoglou, H., Apostolakis, E. and Papadopoulos, G.S. (2011) Are There Independent Predisposing Factors for Postoperative Infections following Open Heart Surgery? Journal of Cardiothoracic Surgery, 6, Article No. 151.
https://doi.org/10.1186/1749-8090-6-151
[16]  Okonta, K.E., Anbarasu, M., Agarwal, V., Jamesraj, J., Kurian, V.M. and Rajan, S. (2011) Sternal Wound Infection following Open Heart Surgery: Appraisal of Incidence, Risk Factors, Changing Bacteriologic Pattern and Treatment Outcome. Indian Journal of Thoracic and Cardiovascular Surgery, 27, 28-32.
https://doi.org/10.1007/s12055-011-0081-9
[17]  Salehi Omran, A., Karimi, A., Ahmadi, S.H., et al. (2007) Superficial and Deep Sternal Wound Infection after More than 9000 Coronary Artery Bypass Graft (CABG): Incidence, Risk Factors and Mortality. BMC Infectious Diseases, 7, Article No. 112.
https://doi.org/10.1186/1471-2334-7-112

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