Comparison of Simple Wire and Figure-of-Eight Technique in Terms of Development and Outcome of Sternal Dehiscence in Patients Undergoing Coronary Artery Bypass Graft Surgery

Objective: To see effects of simple wiring and figure of eight techniques on the development and outcome of sternal dehiscence in patients undergoing Coronary Artery Bypass Grafting Surgery (CABG). Study Design:Retrospective study. Place and Duration: From15/09/2010 to 30/11/2014. The data was retrieved from the cardiac surgery departments of three hospitals i.e. Pakistan Institute of Medical Sciences, Islamabad, Bilal Hospital, Rawalpindi and King Faisal Specialist Hospital and Research Center, Saudi Arabia. Materials and Methods: A total of 250 patients were retrospectively analyzed. Out of these 160 underwent simple wire technique, 60 had figure of eight technique and 30 cases underwent Robicsek technique. All patients underwent similar preoperative preparations for different cardiac procedures mainly Coronary Artery Bypass Grafting Surgery (CABG) and some other cardiac surgeries. The outcome was determined in terms of development of sternal dehiscence and its outcome between the two groups i.e. simple wire technique and figure of eight technique. Results: Average age of patients was found slightly variable in the simple wire (50.0 + 19.0) and figure of eight (45.0 + 18.0) study groups.Male gender was dominant in this study (72.0%) and most of the patients were Diabetic, Chronic respiratory problem with or without history of smoking Chronic renal Disease and also overweight or obese. Overall (8.0%) patients developed deep sternal wound infection (DSWI) and 4.4% had superficial wound infection (SWI). When compared between simple wire and figure of eight techniques both SWI (4.4% vs 3.2%) and DSWI (7.5% vs 8.3%) were equally distributed statistically. Conclusion: The outcome of sternal dehiscence is significantly different among simple wire and figure of eight techniques. Inotropic usage, chest re-exploration, sternal rewiring, superficial wound infections and deep sternal wound infections were all found high in both study groups compared to Robicsek technique.