Prophylactic Negative Pressure Dressing and Sternal Wound Dehiscence Rates in BIMA Surgery, a Propensity-Score Matched Case-Control Analysis

All articles of this category (opens in new window) Background: The study aims to evaluate the protective effects of the negative pressure bandage as a primary prophylactic approach against sternal wound healing disorders after harvesting of both internal mammary arteries in the coronary bypass surgery. Methods: From 5,190 patients operated at a single institution in the period from January 2018 to March 2021, were screened for inclusion in this retrospective analysis. The inclusion criteria were age over 18 years and undergoing a total arterial myocardial revascularization using both internal mammary arteries via median sternotomy. The exclusion criteria were a postoperative mortality in less than 30 days. Patients who fulfilled the criteria were divided into two groups: group 1, who received a prophylactic negative pressure bandage at the end of the procedure, which was continued for at least 7 days, and group 2, who received a standard wound dressing. A 1:1 propensity-score matching was performed to adjust for confounding factors including: Female sex, patient’s age, Class III obesity, Diabetes Mellitus, low preoperative LVEF (1 mg/dL), duration of ICU stay, and duration of hospital stay. Results: A total of 1,089 patients met the inclusion and exclusion criteria. Group 1 initially included 298 patients, and group 2 included 800 patients. After propensity score matching, group 1 included 294 patients and group 2 included 294 patients. Binary logistic regression modeling for the propensity score-matched groups showed no statistically significant association between the use of prophylactic negative pressure dressing and the occurrence of wound healing disorder (odds ratio = 1.278, 95% CI = 0.741 to 2.204, p = 0.377) Conclusion: Negative pressure dressing did not show a protective effect against sternal wound healing disorder after harvesting of both internal mammary arteries during coronary bypass surgery. It should not be used as a standard dressing. Its protective effect in high-risk patients is, however, still to be investigated. Publication History Article published online: 17 February 2026 © 2026. Thieme. All rights reserved. Georg Thieme Verlag KG Oswald-Hesse-Straße 50, 70469 Stuttgart, Germany