To the Editor.—The article by Nugent et al1 described an interesting technique and one that may, in fact, prevent postoperative sternal complications. We2 recently published an article about closure of the pericardium and its use in bilateral internal mammary arteries. We found, in review of our experience over the last several years with roughly 900 coronary bypasses, that we had about a 1% incidence of major sternal wound problems among our patients. We specifically looked at this in reference to our patients who underwent internal mammary artery operations in which we used bilateral grating, and we found the percentage of sternal wound problems to be slightly higher, in the range of 1.5% to 2%. When we broke this down, we found that a large majority of these patients were diabetic, patients with extensive chronic lung disease, and the more elderly patients.3 Since our study, we do
ZOLLINGER RW. Pericardial Flaps Prevent Wound Complications. Arch Surg. 1988;123(12):1526. doi:10.1001/archsurg.1988.01400360096023
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