Between Hope and Risks; Insight on Delayed Sternal Closure Technique Outcomes in Adult Patients underwent Cardiac Operations

Background: the delay of sternal closure after cardiac operations may offer the chance for survival in critical conditions; mainly sever hemodynamic instability and uncontrollable bleeding. Many concerns about hope of survival and possible risks especially mediastinitis or wound infection still represent dilemma for surgeons in such situations. The aim of our study is to evaluate the outcomes of delayed sternal closure technique after cardiac operations.Methods:this prospective study included 28 adult patients. Differentpreoperative, operative patient’s data were collected and postoperative outcomes were recorded.Results: survival rate was 61% of patients; average time till sternal closure was 1.0±2.6 days. Main causes of death were multi-organ failure (n=4), low cardiac output (n=4), sepsis (n=3).Superficial sternotomy wound infection occurred in 3patients (10.7%) while only one patient developed deep sternotomy wound infection.Conclusions : delayed sternal closure is a beneficial technique that may carry the hope of survival for highly critical patients ,  risk of mediastinitis or wound infection were low and should not make the surgeon hesitate to offer the patient this valuable chance for survival when needed.