Citation, DOI, disclosures and article data
Citation:
Weerakkody Y, Hacking C, Knipe H, et al. Sternal dehiscence. Reference article, Radiopaedia.org (Accessed on 13 May 2024) https://doi.org/10.53347/rID-78244
Disclosures:
At the time the article was last revised Craig Hacking had the following disclosures:
- Philips Australia, Paid speaker at Philips Spectral CT events (ongoing)
These were assessed during peer review and were determined to
not be relevant to the changes that were made.
View Craig Hacking's current disclosures
Sternal dehiscence of the median sternotomy closure is an infrequent post sternotomy complication. It may be latent or difficult to detect clinically, or it may be sudden and very obvious. It may lead to sternal non-union. It may or may not be complicated by infection.
It may occur in 0.2-5% of patients post sternotomy and usually happens as a result of primary non-union, poor wound healing or premature overexertion 6.
Patient risk factors include diabetes, smoking, obesity, prolonged post-operative ventilation and bilateral internal thoracic artery grafts 7.
Chest radiograph
It may manifest as a gross or subtle change in position and/or integrity of the sternal wires. Often radiographic features may manifest prior to clinical signs or symptoms 3.
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3. Boiselle P, Boiselle MA, Boiselle FM, Boiselle MT, Boiselle. Wandering Wires: Frequency of Sternal Wire Abnormalities in Patients With Sternal Dehiscence. (1999) AJR. American journal of roentgenology. doi:10.2214/ajr.173.3.10470922 - Pubmed
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4. Arthur E. Li, Elliot K. Fishman. Evaluation of Complications After Sternotomy Using Single- and Multidetector CT with Three-Dimensional Volume Rendering. (2012) American Journal of Roentgenology. 181 (4): 1065-70. doi:10.2214/ajr.181.4.1811065 - Pubmed
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5. Schimmer C, Schimmer RW, Schimmer BS, Schimmer EP, Schimmer SO, Schimmer SH, Schimmer SK, Schimmer GB, Schimmer DO, Schimmer RA, Schimmer FR, Schimmer SC, Schimmer EO, Schimmer LR, Schimmer. Prevention of Sternal Dehiscence and Infection in High-Risk Patients: A Prospective Randomized Multicenter Trial. (2008) The Annals of thoracic surgery. doi:10.1016/j.athoracsur.2008.08.071 - Pubmed
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6. Olbrecht VA, Barreiro CJ, Bonde PN, Williams JA, Baumgartner WA, Gott VL, Conte JV. Clinical outcomes of noninfectious sternal dehiscence after median sternotomy. (2006) The Annals of thoracic surgery. 82 (3): 902-7. doi:10.1016/j.athoracsur.2006.04.058 - Pubmed
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7. Losanoff J, Richman B, Jones J. Disruption and Infection of Median Sternotomy: A Comprehensive Review. Eur J Cardiothorac Surg. 2002;21(5):831-9. doi:10.1016/s1010-7940(02)00124-0 - Pubmed
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