Editorial.

Between January 1987 and April 1988 following 462 open heart surgery operations, 83 patients with icteric hepatitis were seen. Among them 59 patients were anti-HCV positive with the Ortho anti-HCV test, these findings suggested a hepatitis C virus infection. The source of viral infection was searched, and a prothrombin complex concentrate which had been used during that period, seemed to be the potential cause of bloodborne hepatitis C. The results suggest that special care is required when using such blood products.

Cardiac Surgical Procedures↗

PubMed1992

Median sternotomy wound dehiscence: a retrospective case control study of risk factors and outcome.

Over a 5-year period from 1985 to 1989, 2760 patients underwent open heart surgery at the University Hospital of Wales. Of these, 44 (1.6%, 35 men, mean age 61 years) developed median sternotomy dehiscence 2-40 (median 9) days after surgery. Infection was an associated factor in 18 patients (41%) and Staphylococcus aureus the predominant isolate in seven of those. Thirty-seven patients underwent rewiring of the sternotomy wound and seven patients underwent debridement, removal of wires and delayed closure. In those undergoing rewiring, sternal stability was maintained in 34 patients (92%). There were seven deaths (16%), of which two were considered to be wound-related. Median hospital stay of survivors was 34 (range 16-84) days. Comparison with 88 matched controls by univariate analysis showed preoperative chronic obstructive airways disease, reduced FEV1/FVC ratio (both P < 0.001) and smoking (P < 0.05) were all more common in the dehiscence group. In addition, reoperation for bleeding (P < 0.05), prolonged bypass time, postoperative ventilation period and length of stay in the intensive care unit (all P < 0.001) were more common in the study group.

Cardiac Surgical Procedures↗