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Correspondence and Communications Sternal bone anatomy on preoperative imaging as an independent predictor of deep sternal dehiscence following median sternotomy

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ELSEVIER SCI LTD
DOI: 10.1016/j.bjps.2023.11.033

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Sternotomy wounds; Risks stratification; Sternal thickness; Deep sternal dehiscence; Prophylactic plastic surgery

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Complications following median sternotomy are a concern. Plastic surgeons are being consulted to close complex sternotomy wounds, thus a more accurate risk stratification tool is needed. This study examines the association of preoperative radiologic sternal measurements and deep sternal dehiscence, finding that decreased manubrium sternal thickness and absolute inferior sternal width are significantly associated with deep sternal dehiscence.
Complications following median sternotomy are associated with morbidity, mortality, and major healthcare costs. With plastic surgeons being increasingly consulted to close complex sternotomy wounds, a more accurate risk stratification tool for this comorbid patient population is warranted. This study examines the association of preoperative radiologic sternal measurements and deep sternal dehiscence, comparing this with other known clinical risk factors.A decreased manubrium sternal thickness relative to body weight (< 0.13 mm/kg) and an absolute inferior sternal width <= 13.8 mm had a significant association with the development of deep sternal dehiscence, even with adjustment for known clinical risk factors. With such measurements assisting in further risk stratification, the opportunity to improve risk assessment holds value for plastic and reconstructive surgeons who are consulted to close extensive sternotomy wounds. (c) 2023 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd. All rights reserved.

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