Sternotomy is a procedure that allows you to create an access, an operating field, to the chest organs during surgery. It is a surgical cut of the sternum along its long axis. How is this procedure performed and what are the complications of sternotomy?
Sternotomiand is most often performed during cardiac surgery, e.g. valve replacement, suturing of by-passes (coronary aortic bypass surgery) or procedures on large chest vessels.
Sternotomy can also be a component of thoracic surgery: removal of the lung, its part, tumor of this organ (including lymph nodes) or surgery on the esophagus.
Severing the sternum is very rarely necessary during thyroid or thymus surgery.
Sternotomy: cutting and reconstruction of the sternum
Sternotomy is of course performed under general anesthesia.
First, the skin is cut in the midline along the entire length of the sternum, then the subcutaneous tissue and the periosteum are cut. A special saw is most often used to cut the sternum.
Reconstruction of the sternum after the procedure requires the installation of metal, less often plastic, sutures that remain in the body of the operated on for life and are designed to stabilize the sternum until it fuses, the process may take up to several months.
It is worth knowing that all procedures associated with sternotomy are always very serious, significantly weaken the general condition and most often require long-term rehabilitation.
After sternotomy, it is necessary to wear a special vest that stabilizes the sternum and a sparing lifestyle: avoiding strenuous efforts, tightening the chest.
It should also be remembered that after sternotomy it is often necessary to put on drainage, but it is related to the target procedure, and not forced by cutting the sternum.
Sometimes it is necessary to perform an operation with a sternum cut again, then this procedure is calledresternotomy , it is performed using the same technique, but is associated with a higher risk of complications and longer convalescence.
A variation of sternotomy is the so-calledministernotomy , it is sometimes used, for example, in valve surgery. It is a less traumatic procedure, but not in all treatmentsit can be used and the decision to use it is made individually for each patient. A ministernotomy involves cutting the upper or lower part of the sternum up to the 3-4th rib.
Complications of sternotomy
As with any procedure, sternotomy is also associated with the risk of complications, they are rare, such as: infection and dehiscence of the sternum, which is especially common in smokers and people with chronic obstructive pulmonary disease.
In the event of such a complication, it is necessary to drain the infected content, antibiotic therapy, and sometimes also a second operation.
Less frequent complications of sternotomy may include instability of the sternum and damage to the brachial plexus manifested by pain and sometimes partial paralysis of one of the upper limbs.
Of course, such a serious procedure always leaves a visible scar on the chest, which often causes discomfort and shame.
Sternotomy is part of many cardiac and thoracic surgeries and involves cutting the sternum. It is a very serious procedure, after which a long convalescence and rehabilitation is necessary.
Sternotomy, like any procedure, carries the risk of complications, but it is small.
About the author
Bow. Maciej GrymuzaA graduate of the Faculty of Medicine at the Medical University of K. Marcinkowski in Poznań. He graduated from university with an over good result. Currently, he is a doctor in the field of cardiology and a doctoral student. He is particularly interested in invasive cardiology and implantable devices (stimulators).