Prevention of Sternal Wound Infections with the Sternum External Fixation (Stern-E-Fix) Corset in Women

Objectives: Deep sternal wound infection (DSWI) and mediastinitis are devastating complications after median sternotomy due to their association with greater morbidity and mortality. Using an external supportive sternal corset (Stern-E-Fix) is shown to yield a significantly better and effective prevention against development of sternal dehiscence and secondary sternal infection in high-risk post-sternotomy male patients. The aim of this study is to assess the prevention of DSWI after median sternotomy in females with use of the sternum external fixation (Stern-E-Fix) corset.

Methods: This retrospective study (November 2009–November 2012) comprises 145 female patients undergoing standard median sternotomy for cardiac surgery (68% CABG). Patients were divided in two groups, A, n = 71 received a Stern-E-Fix corset postoperatively for 6 weeks and B, n = 74 control group received an elastic thorax bandage (SanThorax). Preoperative preparations were similar in both groups.

Results: In both groups, risk factors for sternal wound infections were similar. Sternal wound infections occurred in n = 5 (7%) patients in group A versus n = 13 (17.6%) in group B (p = 0.025). In group A, only one patient presented with a DSWI versus seven patients in group B (p = 0.063). No patient had mediastinitis in group A versus four in group B. Antibiotic therapy was given for 0.4 ± 2.2 days in group A versus 7.3 ± 21.8 days in group B (p = 0.002). Operative therapy was needed in n = 3 (4.2%) in group A versus n = 12 (16.2%) in group B (p = 0.026). The mean length of stay in hospital was 14.4 ± 7.6 days in group A versus 24.7 ± 24.5 days in group B (p = 0.0006).

Conclusion: The outcome of this study shows that using an external supportive sternal corset (Stern-E-Fix) yields a significant better and effective prevention against development of DSWI in poststernotomy female patients undergoing cardiac surgery.