Intradermal versus Staple Cutaneous Closure of Sternum after Coronary Artery Bypass Grafting: A RetrospectiveComparison

Background: Cardiac surgery infections are infrequent but cause important complications. Predicting their occurrence is essential for future prevention.Objectives: This study aims at determining the difference in wound complication and infection rates between suture and staple cutaneous closure techniques applied to clean sternal incisions in coronary bypass patients at King Abdullah University Hospital, Jordan.Methods and Results: In a retrospective study, 1,338 coronary artery bypass grafting cases have been analyzed from May 5, 2002, to December 31, 2007. A sternal wound was studied retrospectively. 572 patients had wound closed with intradermal (subcuticular) sutures, 766 patients had wound closed with staples. Wounds were categorized as complicated (greater than normal erythema). A complicated wound was identified as infected if the patient had purulent discharge, if antibiotics had been prescribed for cellulites, or drainage procedure had been performed. Wounds were examined at discharge, after discharge at one week in the clinic, and at 3 to 4 weeks after surgery.Results: Significantly lower incidence of total wound complications with intradermal suture closure than with staple closure.Conclusions: Subcuticular suture closure of sternal skin incision is more cosmetic and has a lower infection rate.