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. 2023 Oct 11;21(2):e14424.
doi: 10.1111/iwj.14424. Online ahead of print.

Effect of skeletonisation and pedicled bilateral internal mammary artery grafting in coronary artery bypass surgery on post-operative wound infection: A meta-analysis

Caihong Nie  1 , Yunping Deng  2 , Yongmei Lu  1
Affiliations

Effect of skeletonisation and pedicled bilateral internal mammary artery grafting in coronary artery bypass surgery on post-operative wound infection: A meta-analysis

Caihong Nie et al. Int Wound J. .

Retraction in

Abstract

The results showed that different internal thoracic artery (ITA) was associated with the rate of postoperative wound infection and the severity of pain following coronary artery bypass grafting (CABG). In order to ascertain if there was any genuine difference in the rate of postoperative infection and severity of the pain, we conducted a meta-analysis to evaluate if there was any actual difference in the wound complication that had been identified with the ITA method. Through EMBASE, Cochrane Library and Pubmed, and so forth, we systematically reviewed the results by August 2023, which compared the impact of skeletonised versus pedicled internal mammary artery (IMA) on wound complications following CABG. The trial data have been pooled and analysed in order to determine if a randomisation or fixed-effect model should be applied. The meta-analysis of data was performed with Revman 5.3 software. The results of this meta-study included 252 related articles from four main databases, and nine articles were chosen to be extracted and analysed. A total of 3320 patients were treated with coronary artery transplantation. Based on current data analysis, we have shown that the rate of postoperative wound infections is reduced by the use of the skeletonised internal mammary artery (SIMA) (OR, 1.84; 95% CI, 1.13, 3.01; p = 0.01). But the results showed that there were no statistically significant differences in the post-operation pain score of the patients (MD, 0.09; 95% CI, -0.58, 0.76; p = 0.79). Furthermore, the duration of the operation was not significantly different between the SIMA and pedicled internal mammary artery (PIMA) (MD, 3.30; 95% CI, -3.13, 9.73; p = 0.31). Overall, the SIMA decreased the rate of postoperative wound infection in CABG patients than the PIMA.

Keywords: coronary artery bypass grafting (CABG); pain score; pedicled internal mammary artery (PIMA); skeletonised internal mammary artery (SIMA); wound infection.

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Conflict of interest statement

The authors declare no conflicts of interest.

Figures

FIGURE 1
FIGURE 1
Flow chart of the study.
FIGURE 2
FIGURE 2
Risk of bias diagram.
FIGURE 3
FIGURE 3
Summary of risk of bias.
FIGURE 4
FIGURE 4
Funnel plot of the effects of intraoperative use of skeletonised internal mammary artery compared with conventional pedicled internal mammary artery on post‐operative wound infection status in patients undergoing coronary artery bypass graft surgery.
FIGURE 5
FIGURE 5
Forest plot of the effects of intraoperative use of skeletonised internal mammary artery compared with conventional pedicled internal mammary artery on post‐operative wound infections in patients undergoing coronary artery bypass graft surgery.
FIGURE 6
FIGURE 6
Forest plot of the effects of intraoperative use of skeletonised internal mammary artery compared with conventional pedicled internal mammary artery on patients' post‐operative wound pain scores in subjects undergoing coronary artery bypass graft surgery.
FIGURE 7
FIGURE 7
Forest plot of the effects of intraoperative use of skeletonised internal mammary artery compared with conventional pedicled internal mammary artery on patient operating duration in subjects undergoing coronary artery bypass graft surgery.
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