Effect of bilateral internal thoracic artery harvesting on deep sternal wound infection in diabetic patients: Review of literature. (June 2021)

• Record Type: Journal Article
• Authors: Masroor, Matiullah; Fu, Xianming; Khan, Umar Zeb; Zhao, Yuan
• Is Part Of: Annals of medicine and surgery. Volume 66(2021)
• Publication Date: 2021-06
• Subjects: Bilateral internal thoracic artery (BITA) -- Single internal thoracic artery (SITA) -- Deep sternal wound infection (DSWI) -- Diabetes mellitus (DM) -- Coronary artery bypass grafting (CABG); Surgery -- Periodicals; Medicine -- Periodicals; General Surgery -- Periodicals; Education, Medical -- Periodicals; Periodicals; 617
• DOI: 10.1016/j.amsu.2021.102382
• Languages: English
• ISSNs: 2049-0801

Abstract

Abstract: Instead of its documented superiority of patency and long-term outcomes, the bilateral internal thoracic artery grafts are underused in the general population, and its use is controversial and debatable in diabetic patients due to long surgery duration, post-surgical bleeding, and sternal wound complications such as sternal wound infection, mediastinitis, and sternal wound dehiscence. This review article is particularly focused on deep sternal wound infection (DSWI) of bilateral internal thoracic artery (BITA) grafts in diabetic patients with comparison to single internal thoracic artery (SITA) graft. Highlights: Bilateral internal thoracic artery grafting is superior to single internal thoracic artery grafting in terms of outcomes. Bilateral internal thoracic artery grafting is underused, especially in diabetic patients. The risk of DSWI in skeletonized BITA grafting in diabetic patients is almost similar to SITA grafting. Skeletonized BITA grafting should be encouraged in selected diabetic patients.