During the period of October 1986 to January 1989 we executed 445 sternotomies; 158 of these were for myocardial revascularization. In 92 cases the left internal mammary artery (LIMA) was used. Of 445 cases, 7 patients developed sternal infection in the immediate post operative period. The average time for the infection to appear was 8.7 days (4-15 days). Of these, 6 patients were male with an average age of 48.8 years (35-60 years). All cases were first operations; complicating factors were diabetes (1 case), pulmonic emboly with respiratory insufficiency (1 case), low output syndrome (3 cases), prolonged surgery (1 case) and LIMA dissection (6 cases). With the use of plastic surgery techniques and myocutaneous and muscular flaps, complications were corrected and permitted a more rapid patient recovery, avoiding deaths in this period. The esthetic and functional results were considered excellent. Three small dehiscences were treated in the out-patient clinic. Also of great importance was the identification of the germes by cultures and the treatment based on antibiograms in conjunction with the surgical techniques aplied. In conclusion, we judged that in sternal infections, rapid and aggressive surgery avoided deaths.
sternal infections; myocardial revascularization