Evidence map›Paper›PMID 38530971›Full record

ArticleInterdisciplinary cardiovascular and thoracic surgery2024

Thorax support vest to prevent sternal wound infections in cardiac surgery patients-a systematic review and meta-analysis.

Tulio Caldonazo, Michele Dell'Aquila, Gianmarco Cancelli, Lamia Harik, Giovanni Jr Soletti, Johannes Fischer, Hristo Kirov, Mohamed Rahouma, Mudathir Ibrahim, Michelle Demetres and 4 more

Open access · diamondAbstract read
In one paragraph

Article in Interdisciplinary cardiovascular and thoracic surgery, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
0.6field-weighted citation impact, top 36% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed, 1 citations in OpenAlex.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

14 authors at 4 institutions in 4 countries.

Tulio CaldonazoDepartment of Cardiothoracic Surgery, Jena University Hospital, Friedrich-Schiller-University, Jena, Germany.ORCID 0000-0001-5697-2659
Michele Dell'AquilaDepartment of Cardiothoracic Surgery, Weill Cornell Medicine, New York, NY, USA.
Gianmarco CancelliDepartment of Cardiothoracic Surgery, Weill Cornell Medicine, New York, NY, USA.
Lamia HarikDepartment of Cardiothoracic Surgery, Weill Cornell Medicine, New York, NY, USA.ORCID 0000-0003-1500-1308
Giovanni Jr SolettiDepartment of Cardiothoracic Surgery, Weill Cornell Medicine, New York, NY, USA.
Johannes FischerDepartment of Cardiothoracic Surgery, Jena University Hospital, Friedrich-Schiller-University, Jena, Germany.
Hristo KirovDepartment of Cardiothoracic Surgery, Jena University Hospital, Friedrich-Schiller-University, Jena, Germany.
Mohamed RahoumaDepartment of Cardiothoracic Surgery, Weill Cornell Medicine, New York, NY, USA.
Mudathir IbrahimDepartment of General Surgery, Maimonides Medical Center, Brooklyn, NY, USA.
Michelle DemetresSamuel J. Wood Library & CV Starr Biomedical Information Center, Weill Cornell Medicine, New York, NY, USA.ORCID 0000-0002-4997-7707
Kevin R AnDepartment of Cardiothoracic Surgery, Weill Cornell Medicine, New York, NY, USA.
Leonard GirardiDepartment of Cardiothoracic Surgery, Weill Cornell Medicine, New York, NY, USA.
Torsten DoenstDepartment of Cardiothoracic Surgery, Jena University Hospital, Friedrich-Schiller-University, Jena, Germany.ORCID 0000-0002-6411-909X
Mario GaudinoDepartment of Cardiothoracic Surgery, Weill Cornell Medicine, New York, NY, USA.ORCID 0000-0003-4680-0815
Cornell University · USJena University Hospital · DEMaimonides Medical Center · USUniversity of Toronto · CA

Funding

Deutsche Forschungsgemeinschaft
6 · The paper itself

Abstract

objectivesMidline sternotomy is the main surgical access for cardiac surgeries. The most prominent complication of sternotomy is sternal wound infection (SWI). The use of a thorax support vest (TSV) that limits thorax movement and ensures sternal stability has been suggested to prevent postoperative SWI.

methodsWe performed a meta-analysis to evaluate differences in clinical outcomes with and without the use of TSV after cardiac surgery in randomized trials. The primary outcome was deep SWI (DSWI). Secondary outcomes were superficial SWI, sternal wound dehiscence, and hospital length of stay (LOS). A trial sequential analysis was performed. Fixed (F) and random effects (R) models were calculated.

resultsA total of 4 studies (3820 patients) were included. Patients who wore the TSV had lower incidence of DSWI [odds ratio (OR) = F: 0.24, 95% confidence interval (CI), 0.13-0.43, P < 0.01; R: 0.24, 0.04-1.59, P = 0.08], sternal wound dehiscence (OR = F: 0.08, 95% CI, 0.02-0.27, P < 0.01; R: 0.10, 0.00-2.20, P = 0.08) and shorter hospital LOS (standardized mean difference = F: -0.30, -0.37 to -0.24, P < 0.01; R: -0.63, -1.29 to 0.02, P = 0.15). There was no difference regarding the incidence of superficial SWI (OR = F: 0.71, 95% CI, 0.34-1.47, P = 0.35; R: 0.64, 0.10, 4.26, P = 0.42). The trial sequential analysis, however, showed that the observed decrease in DSWI in the TSV arm cannot be considered conclusive based on the existing evidence.

conclusionsThis meta-analysis suggests that the use of a TSV after cardiac surgery could potentially be associated with a reduction in sternal wound complications. However, despite the significant treatment effect in the available studies, the evidence is not solid enough to provide strong practice recommendations.

Indexed as

Cardiac surgeryOsteomyelitisStabilitySternal wound infectionThorax support vest

Identifiers

PMID38530971
PMCPMC11035004
OpenAlexW4393180423

What OpenQuestion holds

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LicenceCC BY
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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.