New research reveals internal mammary artery skeletonization, a surgical technique, helps reduce chances of serious chest wound infection after heart bypass surgery in patients with diabetes. Dr. Ifeanyi Chinedozi shares the importance of this finding and how it could potentially lead to practice changes.
Good morning, everybody. My name is If Ioi I'm a postdoc fellow here at John FP University, the division of Cardiac Surgery. I'm working with Doctor Jennifer Lawton. Um to present this really um important topic on the protective effect of scan organization of any internal mammary artery uh for aas in diabetic patients. What does this word mean? Ization is a funny word that really means you can think about a skeleton, getting rid of ss tissues in an artery before you use it as a conduit for surgical revitalization, especially in patients with diabetes. Over the years, evidence has emerged regarding the long term benefits of using modern one internal mammary artery, also known as internal thoracic artery. However, in diabetic patients, that is a great sense of reluctance in using two internal mammary artery because of the increased risk of deep sternal wound infection. Although patients have again been known to have benefits long term benefits from the use of bila to R A. Uh surgeons are very wary of using this in diabetic patients. And so our objective here was to evaluate the effect of using bilateral inter one R A on the clinical outcomes in patients who specifically have diabetes. And then to investigate the impact of having at least one of those arteries, skeleton, uh skeletonized or cleaned up prior to use in in diabetic patients, we did evaluate more than 27,000 patients out of which about 764 of them had diabetes and also had more than one internal r used at a time of surgical revascularization. And on the initial analysis in the initial analysis, we did find that in diabetic patients that have bilateral internal mammary artery, they did have a higher rate of deep sternal wound infection. However, when we did a subgroup analysis to look for the impact of cleaning up again, at least one of those hours, we did find that that incidence of decent wound infection really dissipated became comparable in both groups. So the conclusion here therefore is, although deep standard wound infection is a major deterrent in the use of Bilaro in China memory artery. If surgeons can take the time to clean up this artery, that the fear of this terrible infection actually may not be a thing anymore that could be completely eradicated or significantly reduced when we do go through the process of cleaning up the vessel. And so this is this is a really important um subject and we believe it's it's likely to cause some thinking amongst the community of card surgeons and hopefully leads to some significant um practice changes. Now, at least um uh you know, gives the background for more studies in this area of question. Thank you so much. Have a great day.