Korean J Thorac Cardiovasc Surg.
2000 Jan;33(1):20-25.
Wound States in Pediatric Open Heart Surgery with Bilateral Submammary Skin
Incision Combined with Vertical Sternotomy
- Affiliations
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- 1Department of Thoracic and Cardiovascular Surgery, School of Medicine, Kyungpook National University.
Abstract
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BACKGROUND: Median sternotomy remains the standard approach used by surgeons for most
intracardiacscar we have tried to use alternative skin incision (bilateral subm-ammary
skin incision) to median sternal skin incision, In this study we have tried to compare
different postoperative results of wound between two different skin incisional methods.
MATERIAL AND METHOD: Between June 1997 and June 1998, a bilateral subma-mmary skin incision
combined with v operations but the residual scar is cosmetically unsatisfactory. To avoid an
unsightly midline ertical sternotomy was performed in 21 pediatric female patients
(submammary group)to repair acyanotic congenital heart disease. after the period we carried
out a retrograde sion controls in whom there were 23 pediatric patients (control group).
RESULT: Patients' age ranged from 14 to 96 months(mean 38.2 months) Mean duration of subcutaneous drains using Hemovac which was used only in the patients of submammary group was 4.2 days and total amount of the drained effusion was 51.1 ml. Postoperative wound complications included wound eruption in one patient wound disruption in one patient and skin necrosis in 3 patients in submammary group and included wound disruption in 4 patients in controls. mean duration required for wound healing was 15,5 days in submammary group versus 10.4 days in controls. The mean scar length was 12.5 cm in submammary group versus 11.3 cm in controls. The average follow-up was 8.2 months in submammary group versus 9.0 months in controls. In submammary group 3 patients parents(14.3%) were pleased with their cosmetic results of wound scar but 8(38.1%) were dissatisfied. Among the 23 patients in control group 8(34.8%) were pleased but 8(34.8%) complained ofunhappiness with the scar.