Frequency of deep infection of the sternal wound in diabetic patients utilizing skeletonized versus pedicled harvesting technique of internal thoracic artery after CABG surgery.

Abstract

Objectives: After coronary artery bypass graft (CABG) surgery, infection of the sternum is a serious issue as it would adversely affect the mortality of patient. Left internal thoracic artery (LITA) has significant benefits but after its utilization occurrence of sternal infection is documented especially in diabetic patients due to impairment in blood flow of sternum. Our objective was to document the frequency of deep infection of the sternal wound in patients with diabetes utilizing skeletonized versus pedicled harvesting technique of the left ITA after CABG Surgery in our population. Study Design: An observational study was retrospectively done. Setting: National Institute of Cardiovascular Diseases, Karachi. Period: January 2013 to October 2015. Material and Methods: The sample size of the study was determined to be a total of two hundred and twenty patients who had primary, isolated and elective CABG surgery. One hundred and ten patients were included in whom skeletonized left ITA was utilized and in one hundred and ten patients pedicled left ITA was utilized. We used the statistical Chi square test and p < 0.05 was considered significant. Results: Deep infection of the sternal wound occurred in 3.64% of the patients with diabetes in whom the pedicled left ITA was utilized and did not occur in any of the diabetic patients in whom the skeletonized left ITA was utilized. Post CABG surgery frequency of deep infection of the sternal wound was greater in those patients in whom the LITA was harvested utilizing the pedicled technique (p<0.05). Conclusion: There is decreased frequency of deep infection of the sternal wound in patients with diabetes utilizing the skeletonized harvesting technique of the left ITA after CABG Surgery.