Wound Infection after CABG Using Internal Mammary Artery Grafts: A Meta-Analysis
| Autor: | Philippe Grieshaber, Andreas Boening, Joern Pons-Kuehnemann, I. Oswald |
|---|---|
| Rok vydání: | 2020 |
| Předmět: |
Pulmonary and Respiratory Medicine
Sternum medicine.medical_specialty Coronary Artery Disease 030204 cardiovascular system & hematology Cochrane Library law.invention 03 medical and health sciences 0302 clinical medicine Randomized controlled trial law medicine Humans Surgical Wound Infection Mammary Arteries Internal Mammary-Coronary Artery Anastomosis Randomized Controlled Trials as Topic business.industry Incidence (epidemiology) Odds ratio Surgery Newcastle–Ottawa scale Treatment Outcome 030228 respiratory system Meta-analysis Mammary artery Cardiology and Cardiovascular Medicine business Wound healing |
| Zdroj: | The Thoracic and Cardiovascular Surgeon. 69:639-648 |
| ISSN: | 1439-1902 0171-6425 |
| DOI: | 10.1055/s-0040-1713662 |
| Popis: | Background Internal mammary arteries show better long-term patency rates than venous grafts. The use of both mammary arteries is associated with a higher risk of sternal wound infections. This meta-analysis was designed to assess the incidence of a wound healing disorder after bilateral compared with single mammary artery bypass grafting. Compared with existing meta-analysis this paper includes more current literature and one randomized controlled trial. Methods A literature search was performed using PubMed and the Cochrane Library. The quality of the articles was assessed by the Newcastle Ottawa Scale. The odds ratio was used as a measure of the chance of developing a wound healing disorder after bilateral internal mammary artery (BIMA) surgery. Meta-analyses were performed for different subgroups. Results Twenty studies met the quality criteria, including one randomized controlled trial. The use of both mammary arteries significantly increased the risk of superficial (odds ratio [OR] 1.72) and deep (OR 1.75) wound healing disorder in the total population (OR 1.80) as well as in the diabetic subgroup (OR 1.38) and with both preparation techniques. The increased risk with BIMA grafting was present independently of the preparation technique (pedicled: OR 1.89, skeletonized: OR 1.37). Conclusion Bilateral internal mammary artery grafting, especially in high-risk and diabetic patients, is associated with an increased risk of wound healing impairment. Skeletonized preparation does not eliminate the elevated wound healing disorder risk after BIMA use. |
| Databáze: | OpenAIRE |
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