JTCS Sign the Guestbook
HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
QUICK SEARCH:   [advanced]


     

This Article
Right arrow Alert me when this article is cited
Right arrow Alert me if a correction is posted
Right arrow Citation Map
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Add to Personal Folders
Right arrow Download to citation manager
Right arrow Permission Requests
Citing Articles
Right arrow Citing Articles via HighWire
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Josa, M.
Right arrow Articles by Barsamian, E. M.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Josa, M.
Right arrow Articles by Barsamian, E. M.

The Journal of Thoracic and Cardiovascular Surgery, Vol 91, 598-603, Copyright © 1986 by The American Association for Thoracic Surgery and The Western Thoracic Surgical Association

ARTICLES

Delayed sternal closure. An improved method of dealing with complications after cardiopulmonary bypass

M Josa, SF Khuri, NS Braunwald, MF VanCisin, MP Spencer, DA Evans and EM Barsamian

Intraoperative closure of the median sternotomy after cardiac operations in patients with complications, including severe postoperative bleeding, impaired cardiac function caused by myocardial edema, and cardiac dilatation, may lead to a critical and possibly fatal deterioration of hemodynamic function. In an effort to prevent this complication, we delayed mediastinal closure in 15 patients, covering the wound temporarily with a sheet of rubber latex (Esmarch bandage). An oval patch of this material was sized and sutured to the skin edges with a continuous suture. This technique provided easy and fast access to the mediastinal structures in four of the 15 patients who required multiple surgical interventions in the early postoperative period. Delayed closure was indicated for severe bleeding in 10 patients, heart compression in four patients, and severe postbypass arrhythmias in one patient. Definitive closure of the chest was delayed until satisfactory hemostasis was achieved or the heart size returned to normal. Thirteen of the 15 patients were long-term survivors, none of them had wound infections, and their wounds healed well. Delayed closure of the median sternotomy was an effective and safe approach in these groups of critically ill patients.


This article has been cited by other articles:


Home page
 Eur. J. Cardiothorac. Surg.Home page
A. L. Estrera, E. E. Porat, C. C. Miller III, R. Meada, P. E. Achouh, A. D. Irani, and H. J. Safi
Outcomes of delayed sternal closure after complex aortic surgery
Eur. J. Cardiothorac. Surg., June 1, 2008; 33(6): 1039 - 1042.
[Abstract] [Full Text] [PDF]

Home page
 Card Surg AdultHome page
R. Salenger, J. S. Gammie, and T. J. Vander Salm
Postoperative Care of Cardiac Surgical Patients
Card. Surg. Adult, January 1, 2003; 2(2003): 439 - 469.
[Full Text]

Home page
 Eur. J. Cardiothorac. Surg.Home page
K. Samir, A. Riberi, O. Ghez, M. Ali, D. Metras, and B. Kreitmann
Delayed sternal closure: a life-saving measure in neonatal open heart surgery; could it be predictable?
Eur. J. Cardiothorac. Surg., May 1, 2002; 21(5): 787 - 793.
[Abstract] [Full Text] [PDF]

Home page
 Ann. Thorac. Surg.Home page
C. A. Anderson, F. Filsoufi, L. Aklog, R. S. Farivar, J. G. Byrne, and D. H. Adams
Liberal use of delayed sternal closure for postcardiotomy hemodynamic instability
Ann. Thorac. Surg., May 1, 2002; 73(5): 1484 - 1488.
[Abstract] [Full Text] [PDF]

Home page
 Asian Cardiovasc. Thorac. Ann.Home page
M. Mubeen, S. Dan, S. K. Agarwal, A. K. Srivastava, and V. M Kanhere
Delayed Sternal Closure After Cardiac Operations
Asian Cardiovasc Thorac Ann, June 1, 2001; 9(2): 82 - 85.
[Abstract] [Full Text] [PDF]

Home page
 J. Thorac. Cardiovasc. Surg.Home page
S. Tabbutt, B. W. Duncan, D. McLaughlin, D. L. Wessel, R. A. Jonas, and P. C. Laussen
DELAYED STERNAL CLOSURE AFTER CARDIAC OPERATIONS IN A PEDIATRIC POPULATION
J. Thorac. Cardiovasc. Surg., May 1, 1997; 113(5): 886 - 893.
[Abstract] [Full Text]

Home page
 Ann. Thorac. Surg.Home page
H. Satoh, K. Sakai, M. Koyama, and H. Matsuda
Spool-Like Stent for the Open Sternum After Cardiac Operations
Ann. Thorac. Surg., February 1, 1997; 63(2): 572 - 574.
[Abstract] [Full Text]

Home page
 Ann. Thorac. Surg.Home page
M. T. McEnany
Sternal Traction After Open Heart Operation: An Effective Alternative to Delayed Sternal Closure
Ann. Thorac. Surg., August 1, 1995; 60(2): 387 - 391.
[Abstract] [Full Text]

Home page
 VASC ENDOVASCULAR SURGHome page
S. Shimokawa, H. Toyohira, H. Saigenji, S. Fukuda, Y. Moriyama, M. Koga, H. Iwamura, R. Toda, H. Masuda, and A. Taira
Delayed Sternal Closure Following Operation of Type-A Acute Aortic Dissection
Vascular and Endovascular Surgery, July 1, 1995; 29(4): 281 - 285.
[Abstract] [PDF]

Home page
 Ann. Thorac. Surg.Home page
V. Alexi-Meskishvili, Y. Weng, F. Uhlemann, P. E. Lange, and R. Hetzer
Prolonged Open Sternotomy After Pediatric Open Heart Operation: Experience With 113 Patients
Ann. Thorac. Surg., February 1, 1995; 59(2): 379 - 383.
[Abstract] [Full Text]

Home page
 J. Thorac. Cardiovasc. Surg.Home page
M. Hakimi, H. L. Walters III, W. W. Pinsky, M. J. Gallagher, and J. M. Lyons
Delayed sternal closure after neonatal cardiac operations
J. Thorac. Cardiovasc. Surg., March 1, 1994; 107(3): 925 - 933.
[Abstract] [Full Text]


HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
ANN THORAC SURG ASIAN CARDIOVASC THORAC ANN EUR J CARDIOTHORAC SURG
J THORAC CARDIOVASC SURG ICVTS ALL CTSNet JOURNALS
Copyright © 1986 by The American Association for Thoracic Surgery.