A Comparative Study of Median Sternotomy and Standard Thoracotomy Wound Skin Closure Methods

Summary

Complications from skin closure after median sternotomy or standard thoracotomy incision, although uncommon, may be the source of undesireable morbidity and even death.

A prospective randomized study of 3 different methods of wound skin closure has been carried out in 205 patients undergoing cardiothoracic surgery. These methods were:

1. continuous nylon vertical mattress suture;

2. continuous subcuticular absorbable (Dexon) suture;

3. adhesive sutureless skin closure (Op-Site).

All wounds were examined by independent observers at 5, 10 and 45 days after operation, and the findings were graded from 0 to 4. At 5 days, assessments were made of inflammation, edema, discharge and infection. At 10 days, attention was paid to the state of wound healing, and at 45 days to the final cosmetic appearance.

The use of continuous subcuticular Dexon suture resulted in less discharge than Op site (p < 0.001) and less swelling or redness than nylon (p < 0.001). Assessment of the final cosmetic appearance of the wound 6 weeks following surgery showed subcuticular Dexon to be superior to either nylon (p < 0.01) or Op-site (p < 0.01).

Key words

Thoracotomy - Sternotomy - Wound healing skin closure methods