Sternal dehiscence in patients with and without mediastinitis

The authors compared patients with sternal dehiscence CSD) with and without mediastinitis with respect to: 1) time interval from surgery to diagnosis; and 2) frequency of sternal wire abnormalities on chest radiographs (CXR). Using a hospital information system to identify all patients with a diagno sis of SD from January 1993 through April 1999, the authors obtained clinic al data by performing a retrospective chart review. For each patient, a CXR from the date of diagnosis of SD was retrospectively compared with the fir st postoperative CXR to assess for sternal wire displacement, rotation, and disruption, The timing of sternal wire alterations was correlated with cli nical findings of SD or mediastinitis. The authors found that sternal wire abnormalities are evident radiographically in the majority of SD patients w ith and without mediastinitis; there is no significant difference in the fr equency of sternal wire abnormalities between these two subgroups. Patients with SD and mediastinitis generally present later in the postoperative per iod than patients with isolated dehiscence.