STERNAL PLATING IN OBESE PATIENTS UNDERWENT CARDIAC SURGERY IN MAYO HOSPITAL LAHORE

Overview: Patients who undergo cardiac surgery and are “morbidly obese”, surgery which specifically involves sternotomy, they have a risk of sternal dehiscence that is higher than normal. We have tried to examine the use of transverse sternal plating to find a potential solution which involves primary sternal closing in morbidly obese patients. Methods: The data is reviewed retrospectively in the patients who were undergoing cardiac surgery involving primary reinforcement of sternal closure through xiphoid transverse titanium plate. This study was prepared from December 2017 to December 2018. We studied the outcomes of obese patients who underwent cardiac surgery with and without the use of sternal plate reinforcement. The patients who were included in the study had a BMI of 35kg/m2 or more. Results: All patients included in the two groups had about the same demographics and morbid rates (P > 0.05). The follow up of sternal plate reinforcement had been reported 27 months post operation. Range of such patients was between months 8.4 to 49.3. One of the patients (P = 0.4, 7.1%) who had standard closure came to develop sterile sternal dehiscence. The postoperative use of morphine was found to be higher in patients without sternal plate reinforcement (P = 0.008, 1.3mg/h vs 3.6mg/h for patients without sternal plate reinforcement). Wound seroma was not evident in sternal plate reinforcement also the perioperative complications were to be attributed to this technique. Conclusion: Post-operation narcotics usage can be lowered using the technique of sternal plate reinforcement and it can also decrease the risk of developing sternal dehiscence found to be true in this study