Deep sternal wound infections continue to be an uncommon but potentially devastating complication of cardiac surgical procedures. Numerous risk factors have been identified but only a few can be characterized as modifiable. These risk factors and their modifications are reviewed in the following article.
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Pediatric patients undergoing cardiothoracic surgery are at increased risk for health care-associated infections, especially surgical site infections (SSIs). Delayed sternal closures are associated with prolonged lengths of stay and contribute to infection risks and morbidities. At a single-site academic pediatric center, we created an SSI-prevention bundle targeting the preoperative, intraoperative, and postoperative care periods.
View Article and Find Full Text PDFAn Innovative Use of Maxillofacial Implants for the Open Reduction and Internal Fixation of a Displaced Sternal Fracture: A Case Report.
Cureus
December 2024
Oral and Maxillofacial Surgery, Nagoya Tokushukai General Hospital, Kasugai, JPN.
Sternal fractures resulting from blunt chest trauma often present unique surgical challenges. While conservative management is common, cases with significant displacement, delayed union, or painful dyspnea may require surgical intervention to improve structural stability and relieve symptoms. Here, we report the case of a 46-year-old man who sustained a displaced sternal fracture in a motor vehicle accident.
View Article and Find Full Text PDFBeating-Heart Coronary Artery Bypass grafting (BH-CABG) in patients with End-Stage Renal Disease (ESRD): comparison of the Society of Thoracic Surgeons (STS) predicted risk with actual outcomes.
J Cardiothorac Surg
January 2025
Department of Surgery, Division of Cardiac Surgery, Jefferson-Einstein Medical Center Philadelphia, Philadelphia, PA, USA.
Background: End-Stage Renal Disease (ESRD) is an independent risk factor in outcomes for traditional coronary artery bypass grafting (TRAD-CAB) utilizing aortic cross-clamping and cardioplegic arrest. In order to determine if Beating-Heart CABG (BH-CABG) techniques offer benefit in patients with ESRD, an analysis of the Society of Thoracic Surgeons (STS) predicted risk versus the actual outcomes was performed.
Methods: Between March 2017 - October 2023, all ESRD patients underwent BH-CABG by a single surgeon at a single institution.
Assessing the role of chest CT in minor blunt trauma: evaluation of the NEXUS decision instrument across an expanded population.
Eur J Trauma Emerg Surg
January 2025
Emergency Department, Tel Aviv Sourasky Medical Center, 6 Weizman Street, 6423906, Tel Aviv, Israel.
Objective: To evaluate the NEXUS Chest CT ALL decision instrument (DI) in reducing unnecessary chest CT imaging in minor blunt trauma patients while preserving high sensitivity for detecting clinically meaningful injuries. Additionally, we examined the impact of delayed presentation, chronic disease, and anticoagulation/anti-aggregation medications on trauma outcomes.
Methods: This retrospective study included 853 adult minor blunt trauma patients who underwent chest CT in the emergency department (ED) of Tel-Aviv Sourasky Medical Center between 2018 and 2022.
The differences in injury patterns and outcomes of thoracic trauma between rural and urban level two trauma centers in a single country.
Eur J Trauma Emerg Surg
January 2025
Thoracic and Esophageal Surgery Division, The Cardiovascular Institute, Tzafon Medical Center, Baruch-Padeah, Poriya, Galilee, Israel.
Purpose: Equal level trauma centers in the same country might have significant differences regarding their demographics and types of trauma. Understanding geographic variations in injury patterns are essential for optimal care. Here we describe the differences in injury patterns and associated outcomes of thoracic trauma patients between rural and urban level-II trauma centers in a single country.
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