A new classification of post-sternotomy dehiscence

• Published in: Revista brasileira de cirurgia cardiovascular Vol. 30; no. 1; pp. 114 - 118
• Main Authors: Anger, Jaime, Dantas, Daniel Chagas, Arnoni, Renato Tambellini, Farsky, Pedro Sílvio
• Format: Journal Article
• Language: English
• Published: Brazil Sociedade Brasileira de Cirurgia Cardiovascular 01.01.2015
• Subjects: Anatomy & physiology; CARDIAC & CARDIOVASCULAR SYSTEMS; Cardiac Surgical Procedures - methods; Cardiology; Cardiovascular disease; Complicações pós-operatórias; Esterno; Female; Heart surgery; Humans; Infecção da ferida operatória; Male; Risk Factors; Sternotomy - methods; Sternum - surgery; SURGERY; Surgical outcomes; Surgical techniques; Surgical Wound Dehiscence - classification; Surgical Wound Dehiscence - surgery; Toracotomia; Toracotomia; Infecção da ferida operatória; Sternum; Complicações pós-operatórias; Surgical wound infection; Esterno; Thoracotomy; Postoperative complications
• ISSN: 0102-7638; 1678-9741; 1678-9741
• DOI: 10.5935/1678-9741.20140033

The dehiscence after median transesternal sternotomy used as surgical access for cardiac surgery is one of its complications and it increases the patient's morbidity and mortality. A variety of surgical techniques were recently described resulting to the need of a classification bringing a measure of objectivity to the management of these complex and dangerous wounds. The different related classifications are based in the primary causal infection, but recently the anatomical description of the wound including the deepness and the vertical extension showed to be more useful. We propose a new classification based only on the anatomical changes following sternotomy dehiscence and chronic wound formation separating it in four types according to the deepness and in two sub-groups according to the vertical extension based on the inferior insertion of the pectoralis major muscle.