Y incision for median sternotomy.

Between July 1968 and June 1977, in the University of Hong Kong Department of Surgery, 1,083 patients underwent operations via a median sternotomy using a Y incision. Of these patients, 1,070 had open heart surgery, eight had total thymectomy and in five patients pericardectomy was carried out. The overall wound complication rate was 2.31%, with a wound infection rate of 1.24%. The main advantage of a Y incision is that it leaves a better cosmetic appearance than the usual vertical incision because the upper end of the scar is at a much lower level. The incidence of subcutaneous haematoma and subsequent wound infection is much lower with the Y incision, whereas the T incision is associated with a high rate of both these complications due to the large upper flap that one has to create and mobilize to expose the suprasternal area. While using the Y incision, one only requires a small V-shaped upper flap to obtain access to the suprasternal space.