الفهرس 
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Abstract
Median sternotomy is considered to be the gold standard incision for
many open-heart operations including coronary artery bypass grafting
(CABG).However, it is not without complications .The incidence of
postoperative wound infection and morbidity ranges between 0.5% and
8%.
The risk of developing post-operative mediastinitis is dependent on
many factors such as off-midline sternotomy, osteoporosis, prolonged
cardiopulmonary bypass, transverse fractures of the sternum, and bilateral
internal mammary artery harvesting. Other risk factors for sternal
dehiscence include patients’ co-morbidities (chronic obstructive
pulmonary disease (COPD), renal failure, diabetes mellitus, chronic
steroid use, obesity), redo operations, concurrent infection, and prolonged
postoperative respiratory support.
Sternal wound infections are significantly related to levels of
obesity. High Body Mass Index increases the length of stay in operation
room and intensive care unit (ICU) (ventilation time).
The established closure technique uses steel wires in either figure 8
or simple interrupted suturing methods. In this typical technique, the steel
wires are pushed across each half of sternum, however peri-sternal and
pericostal placement appears to reduce sternal damage and weakening of
sternal wire.
Some researchers are strongly in favor of figure of 8 sternal wire
closure technique and believe it to be more secure and less likely to cut
the sternum, because of redistribution of shearing forces, compared to
simple interrupted closure. However, disruption of a single figure-of-8
suture is equivalent to that of 2 interrupted sutures. Biomechanical studies on human cadavers and animals have assessed the efficacy of these
techniques, with different results.
This study aimed to compare the sternal stability, wound infection
and other complications in patients undergoing CABG with steel sternal
closure using figure-of-8 vs simple interrupted closure.
This was a prospective randomized study carried on 60 patients
presented to Menoufia University Hospitals scheduled to coronary artery
bypass grafting (CABG) randomly divided into two groups, 30 patients
for each group, as patients of group A: included 30 patients who was
undergo figure-of-8 closure of sternum and Patients of group B: included
30 patients who was undergo simple interrupted closure of sternum
during the period from March 2019 to March 2021.