BREAST SIZE AS A RISK FACTOR FOR STERNAL WOUND COMPLICATIONS FOLLOWING CARDIAC-SURGERY

Objective: To determine if macromastia is associated with risk for dee p sternal wound infection following cardiac surgery via median sternot omy incision. Design: Case-control study. Setting: Private urban teach ing hospital. Participants: Women who developed deep sternal wound inf ection after undergoing cardiac surgery via median sternotomy incision and a random sample of women who did not develop infection following the same surgery. Outcome measures: Odds ratios (ORs) were used to com pare the development of deep sternal wound infection in women who wore large bra cups (size D or DD) with women who wore small bra cups (siz e A or B) and to compare women who wore medium bra cups (size C) with those who wore small bra cups. Results: For women who wore large bra c ups, the OR for deep sternal wound infection was 38.5 (95% confidence interval [CI], 5.6 to 265.8) compared with women who wore small bra cu ps. For women who wore medium bra cups, the OR for deep sternal wound infection was 12.3 (95% CI, 2.2 to 68.7). The multivariate adjusted OR s, controlling for body mass index, internal mammary artery grafting, diabetes, and age, were 42.1 (95% CI, 3.7 to 477.3) for women who wore large bra cups compared with women who wore small bra cups and 14.9 ( 95% CI, 1.7 to 129.7) for women who wore medium bra cups compared with women who wore small bra cups. Conclusions: Large and medium bra cup sizes are associated with an increased risk for deep sternal wound inf ection after undergoing cardiac surgery via median sternotomy incision .