Longitudinal-cross-linking method of the sternum osteosynthesis – an additional way for the prophylaxis of deep sternal infection in cardiac surgery patients

Q4 Medicine
D. Kuznetsov, A. Gevorgyan, V. V. Novokshenov, K. Mikhailov, A. V. Kryukov, S. Khokhlunov
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引用次数: 0

Abstract

The OBJECTIVE of the study was to compare the results of using the longitudinal – cross-linking method of sternum osteosynthesis with other methods (single wire stitches, 8-shaped wire stitches) for cardiosurgery patients.METHODS AND MATERIALS. The study included 3,150 patients, which were operated on in Samara cardiology dispensary named after V. P. Poliakov from 2012 to 2018. Patients were divided into 2 groups. Group 1 (1397 patients, operated on from 2012 to 2014) used single wire stitches or 8-shaped wire stitches for sternum osteosynthesis. Group 2 (1753 patients, operated from 2015 to 2018) used the longitudinal -cross-linking method of sternum osteosynthesis. The incidence of instability of the sternum without infection, superficial postoperative wound infection, deep sternal infection and hospital mortality were evaluated.RESULTS. Groups (1–68 % of men, average age (59.4±9,9) years; 2–68 % of men, average age 62.3±8.5) were significantly different in obesity patients (25.6 & 29.3 %, p=0.02), amount of smokers (50.5 & 64.2 %, p<0.001) and amount of urgent cases (3 & 10 %, p<0.001). The incidence of sternal instability without infection was less in group 2 (0.64 & 0.29 %; OR, 2.29; 95 % CI, 0.76 to 6.8; p=0.1). The amount of deep sternal infection was significant less in group 2 (1.6 & 0.6 %; OR, 2.53; 95 % CI, 1.2 to 5.2; p=0.009). The hospital mortality was 3.9 % in group 1 and 2.96 % in group 2 (OR, 1.34; 95 % CI, 0.9 to 1.9; p=0.1).CONCLUSION. The longitudinal-cross-linking method of sternum osteosynthesis is the available method that can significantly reduce the incidence of deep sternal infection in cardiosurgery.
胸骨纵向交联法——预防心脏手术患者胸骨深部感染的另一种方法
本研究的目的是比较胸骨纵向交联法与其他方法(单线针、8形线针)在心脏外科患者中的应用效果。方法和材料。该研究包括3150名患者,这些患者于2012年至2018年在以V. P. Poliakov命名的萨马拉心脏病学药房接受手术。患者分为两组。组1(2012 - 2014年手术1397例)采用单线针或8形线缝合胸骨。第二组1753例,2015 - 2018年行胸骨纵向交联成骨术。观察两组无感染胸骨不稳发生率、术后浅表伤口感染发生率、胸骨深部感染发生率及住院死亡率。组(1 ~ 68%)男性,平均年龄(59.4±9.9)岁;肥胖患者(25.6% & 29.3%,p=0.02)、吸烟人数(50.5% & 64.2%,p<0.001)、急症人数(3% & 10%,p<0.001)与男性(2 ~ 68%,平均年龄62.3±8.5)有显著性差异。2组无感染胸骨不稳发生率较低(0.64% & 0.29%;或者,2.29;95% CI, 0.76 - 6.8;p = 0.1)。2组胸骨深部感染发生率明显低于对照组(1.6%、0.6%;或者,2.53;95% CI, 1.2 - 5.2;p = 0.009)。组1住院死亡率为3.9%,组2住院死亡率为2.96% (OR, 1.34;95% CI, 0.9 ~ 1.9;.CONCLUSION p = 0.1)。胸骨纵向交联法是目前可以显著降低心脏外科胸骨深部感染发生率的可行方法。
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来源期刊
CiteScore
0.30
自引率
0.00%
发文量
40
审稿时长
8 weeks
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