Sternal Wound Complications: Objective Reclassification and Surgical Reconsideration.

Backgroundː Sternal wound complications pose a tremendous challenge post cardiac surgery and still no consensus or clear guidelines to deal with them, so we propose simple and more objective classification helps in organising the range of sternal wound complications and suggests a relevant treatment strategy. Methodsː 116 cases of sternal wound complications were reviewed retrospectively out of 2391 adult patients underwent full sternotomy for almost cardiac surgery indications from 2006 to 2018. 86 cases of them were managed conservatively and the other 30 required surgical intervention. More objective classification was proposed and less invasive fasciocutaneous flap was reconsidered for almost reconstructive indications. Resultsː The incidence of Sternal wound complications was 4.8%. Conservative management was adopted for 86 cases, mean duration was 11.19±9.8 days. Surgical management was performed in 30 patients (25.86%), twenty eight (93.3%) of them recovered with good outcomes of less invasive fasciocutaneous flap done for 13 cases. Two cases had recurrence, one was managed conservatively and other was reoperated and healed well. The commonest organisms in recurrent infections were N. coagulase (29.8%) Klebsiella (12.5%), pseudomonas (10.5%), and MRSA (10.5%). We had 4 mortalities; all are not related to sternal wound complications and one related to the cardiac surgery. Conclusionsː Sternal wound complications are grave events, objective classification and selecting proper management are warranted to gain better outcomes.