Significant Predictors of Complications After Sternal Wound Reconstruction: A 21-Year Experience

BackgroundWe sought to identify patient comorbidities that predict complications after tissue flap sternal reconstruction. MethodsA 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 &khgr;2 test, Fisher exact test, 2-sample t test, and median-unbiased estimation were used for data analysis. Significance was P ⩽ 0.05. ResultsIn 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). ConclusionsResults suggest DM, HTN, and CHF may contribute to complications after tissue flap repair of sternal wounds, possibly through impaired perfusion and healing of repairs.

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