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Eur J Cardiothorac Surg 2003;23:435-436
© 2003 Elsevier Science NL

Letter to the Editor

Reply to Losanoff et al.

Ivar Risnes*

Department of Thoracic and Cardiovascular Surgery, Rikshospital, Oslo University, N-0027 Oslo, Norway

* Tel.: +47-2307-3559; fax: +47-2307-3741
e-mail: ivar.risnes{at}rikshospitalet.no

Key Words: Median sternotomy • wound closure • wound infection

We thank James W. Jones for his comments to our article on sternal wound closure. Losanoff's article [1] was not yet published when we prepared our own manuscript. This paper stated that high-risk patients, particularly those with immunosuppression, diabetes and osteoporosis should be identified. We excluded immunosuppression. We did not find diabetes to be a significant risk factor of wound infection, and we have no objective method to identify the degree of sternal osteoporosis. We agree that there are more potential risk factors than the 21 considered in our own study. The identification of a high incidence of wound infection in our patients may hopefully result in a series of new investigations, that may clearify the role of futher risk factors. We are aware of Chimochowsky's use of intranasal mupirocin after surgery [2]; however, this study was not randomized.

References

  1. Losanoff J.E., Jones J.W., Richman B.W. Primary closure of median sternotomy: techniques and principles. Cardiovasc Surg 2002;10:102-110.[CrossRef][Medline]
  2. Cimochowsky G.E., Harostock M.D., Brown R., Bernardi M., Alonzo N., Coyle K. Intranasal mupirocin reduces sternal wound infection after open-heart surgery in diabetics and nondiabetics. Ann Thorac Surg 2001;71:1572-1578.[Abstract/Free Full Text]




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