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| |  CSPS MEETING: Plastic Surgery Speeds Recovery After Open Heart Surgery VICTORIA, BC -- May 22, 1998 -- The costs and recovery time of open-heart surgery complications can be significantly reduced by plastic surgery, according to a new study. Dr. Slobodan Djurickovic presented details here today of his retrospective study of 3,987 patients undergoing cardiac surgery between 1982 and 1996 at the 52nd annual meeting of the Canadian Society of Plastic Surgeons. The study compared the differences between two wound management procedures: open wounds allowed to heal on their own -- the traditional recovery method - versus healing assisted by plastic surgery. "The results were conclusive," Djurickovic said. "Patients undergoing the local muscle flap closure expressed a higher rate of satisfaction than those whose wounds were left to heal on their own. "Patients experienced less pain, recovered much quicker, felt significantly less limited in their day-to-day living and expressed greater overall satisfaction in the cosmetic outcomes." Thousands of Canadians undergo open-heart surgery annually. Between one to three percent of the surgical wounds do not heal well with the surrounding tissue or sternal bones subsequently becoming infected. The chest must therefore be reopened surgically, the dead bone or tissue removed and the wound cleaned. Traditionally this wound -- often three to 10 cm in diameter -- is left open, covered with a dressing and left to heal on its own. The dressings must be changed several times per day. As an open wound, it is predisposed to infection. "Typically patients require between three to six months of daily nursing care to help care for the wound. Some of the patients we studied indicated that it took up to three years for their wounds to fully heal," Djurickovic said. "Living with an open wound for this period of time is enormously inconvenient, not to mention tremendously restrictive for day-to-day activity." With local muscle flap closure, a technique used by plastic surgeons, once the infected or dead tissue is removed from the chest and the wound is cleaned and treated, the patient's chest and abdominal muscles are raised and transposed to close the open cavity. Tissue and skin from the patient are then used to fully close the wound. Among the outcomes measured between the two approaches were length of hospital stay, wound care requirements, and rate of complications: -- On average, muscle flap surgery patients stayed in hospital 19 days, versus 36 days for the traditional method. "At a time when all Canadians are concerned about rising healthcare costs and are seeking to minimise the costs to society of post-surgical patient rehabilitation, we have clearly identified one highly-effective solution," Djurickovic said. "The field of plastic surgery deals functionally with open wounds. Generally speaking, this is not well understood, even among our colleagues in other medical disciplines."
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