Sternal wound infection after myocardial revascularization with internal mammary artery.

ABSTRACT

The use of the bilateral mammary artery in myocardial revascularisation in diabetic patients has been thought to increase the risk of sternal wound infection. We studied unilateral IMA grafting retrospectively in 701 consecutive patients to determine the incidence of sternal wound infection. One hundred and six patients were diabetic; 595 were non-diabetic. Both groups of patients were comparable for age, number of bypasses, and cardiopulmonary bypass time. No patient in the diabetic group developed mediastinitis; two patients of 595 in the non-diabetic group (0.3%) developed mediastinitis. Incidence of subcutaneous wound infection was slightly higher in the diabetic group than in the non-diabetic group (2% vs 0.3%) but was not statistically significant. We conclude that unilateral internal mammary artery grafting in diabetics is not associated with increased risk of sternal wound infection and should remain the conduit of choice for myocardial revascularization.