International Medical Journal, Vol. 25., Iss. 1, 2019, P. 19−22.
EXPERIENCE OF COMBINED TREATMENT OF PATIENTS WITH CARDIAC SURGERY PATHOLOGY AFTER PERFORMED MEDIAN STERNOTOMY
SI "V. T. Zaytsev Institute of General and Emergency Surgery of the National Academy of Medical Sciences of Ukraine", Kharkiv
Kharkiv Medical Academy of Postgraduate Education, Ukraine
Today, as a result of the growing cardiovascular morbidity among the population of most countries, the number of surgical interventions in heart and large vessels is steadily increasing. The rapid development of medicine over the recent decades has allowed expanding the indications for the implementation of challenged surgeries in the patients with severe concomitant pathology. The most common access to such surgeries is median sternotomy. The problem of post−surgery sternotomy−associated complications has remained, i.e. failure of sternal sutures, infection of soft tissues of anterior chest and mediastinum, bleedings. The aim of the work was to improve the results of surgical treatment of cardiac patients subjected to median sternotomy surgery, by improving sternorrhaphy and intraoperative hemostasis. There was retrospectively analyzed 1,331 the medical histories of the patients suffered from a wide variety of cardiac surgical pathologies. After the implementation of longitudinal median sternotomy with access to heart, various methods of surgical hemostasis and osteosynthesis of the sternum were used. In most cases, the concomitant pathology of patient aggravated the course of the underlying disease and had a prognostic value for normal healing of the wound in post−surgery period. The results of this study make it possible to recommend, when performing sternotomy, the use of the proposed method of sternal metal ostheosynthesis in combination with the application of collagen−based hemostatic material.
Key words: median sternotomy, sternorrhaphy, post−surgery suppurative mediastinitis.