Sternotomy Case Study

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A median sternotomy remains the preferred and easiest mode of access to the heart and coronaries because it provides excellent mediastinal exposure. Healing complications after median sternotomy include instability with nonunion of the sternum and infection. This occurs in 0.3% to 5% of all cases and is associated with a mortality rate of 14% to 47%, especially if mediastinitis supervenes.
In the last decade, the risk of wound complications has been raised because of the increasing number of patients with increased risk (e.g., age, diabetes, total arterial revascularization, bilateral ITA harvesting and more complex operations).
The only cohesive force acting upon the reunited sternum in the initial early postoperative period is the holding
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b- Obese c- Diabetic. d- Age above 60yrs. e- Female gender patients. f- Patients with COPD. g- Heavy smokers. exclusion criteria:
1- Any patient with a previous sternotomy.
2- Any patient with preserved LIMA.
3- Any immuno-compromised patient.
4- Any patients who undergone re-opening.
5- Patients who had postoperative complications (renal failure, reopening, stroke, hepatic failure, chest infection, and CPR).
6- Any preoperative patients with hepatic dysfunction, renal dysfunction, blood disease, or congenital thoracic cage anomylus.
7- Any preoperative patients who had been taking chemotherapy, radiotherapy or immune-suppressive drugs.


All patients who are involved in this study should make a consent before subjecting them to the following measurements before, during or after the surgery:
1- Medical history is taken for age, gender, socio-economic status, age at operation, risk factors including COPD, DM or Obesity.
2- Clinical examination post-operative including post-operative, wound infection, the stability of the sternum, back to normal activities after 6 weeks.
3- radiological imaging:
PA and Lateral view x-ray showing: sternum gapping, fracture, and wire cutting through
4- CT in some

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