Risk of deep sternal wound infection of Pedicled versus Skeletonized Left Internal Mammary Artery in Diabetic patients Undergoing Coronary Artery Bypass Graft Surgery

Abstract

Background: Diabetes is a major risk factor of IHD and responsible of many postoperative complications. Deep sternal wound infection after CABG is a major complication which associated with high mortality. Objectives: is to compare between pedicled and skeletonized LIMA in diabetic patients undergoing CABG. Patients and Methods: This study conducted on 100 diabetic patients underwent isolated CABG in the period between January 2017 and January 2018. Patients were divided into 2 groups: Group (A) patients had a pedicled LIMA (n=60) and Group (B) patients had a skeletonized LIMA (n=40). All patients in both groups were followed up during hospital stay and for one month after discharge for symptoms and signs of deep sternal wound infection. Results: Regarding intraoperative date there was significant increase in total operative time in Group (B) was 221±76.5 versus 195±53 in Group (A) (P=-0.003) and no significant difference in other operative data. Regarding postoperative data there was significant increase in incidence of deep sternal wound infection in Group (A ) 6 patients (10%0 versus 1 patient (2.5%) in Group (B) with (P=0.004) while other data showed no statistical difference in both groups, there was no mortality in both groups. Conclusion: Skeletonized LIMA is better to be used than pedicled LIMA in diabetic patients undergoing CABG.