Discriminate use of electrocautery on the median sternotomy incision
| Autor: | Hiroshi Nishida, Ronald K. Grooters, Hooshang Soltanzadeh, Kent C. Thieman, Robert F. Schneider, Won-Pa Kim, Ralph A. Dorner |
|---|---|
| Rok vydání: | 1991 |
| Předmět: |
Pulmonary and Respiratory Medicine
medicine.medical_specialty Surgical team business.industry medicine.medical_treatment Soft tissue Retrospective cohort study medicine.disease Mediastinitis Surgery Exact test Median sternotomy Hemostasis Medicine Cardiology and Cardiovascular Medicine business Complication |
| Zdroj: | The Journal of Thoracic and Cardiovascular Surgery. 101:488-494 |
| ISSN: | 0022-5223 |
| DOI: | 10.1016/s0022-5223(19)36732-7 |
| Popis: | Between June 1978 and June 1989, superficial or deep mediastinitis (or both) developed in only five (0.16%) of 3118 consecutive patients. All patients studied underwent cardiac procedures through a median sternotomy and survived more than 7 postoperative days. The surgical team disciplined itself to divide presternal soft tissues with a scalpel and used electrocautery for pinpoint hemostasis only. This 0.16% infection rate was statistically significantly lower than those in 28 previously published studies (Pearson's chi 2 test, p less than 0.05). Twenty-four predisposing factors were evaluated by Fisher's exact test. Among these only an operating time longer than 3 hours is related to sternotomy infections (p = 0.0208), and this effect was not a strong one. Statistical evidence strongly suggests that discriminate use of electrocautery is a major reason for the lowest median sternotomy infection rate reported to date. |
| Databáze: | OpenAIRE |
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