Table 1.
Two Risk Assessment Tools for Sternal Complications After Cardiac Surgery: (1) Deep Sternal Wound Dehiscence Risk Score and (2) MUST Score
| Deep Sternal Wound Dehiscence Risk Score | MUST Score |
|---|---|
| Variable (points) | Variable (points) |
| BMI, kg/m2 | BMI, kg/m2 |
| <26 (0) | >35 (4) |
| 26–29 (2) | 25–35 (1) |
| 30–37 (4) | Sex |
| >38 (7) | Male (1) |
| Sex | Diabetes |
| Male (0) | Noninsulin-dependent (1) |
| Female (4) | Insulin-dependent (2) |
| HbA1c | Smoking |
| <5.7 (0) | Current (2) |
| 5.7–6.6 (2) | Former (1) |
| 6.7–9 (3) | COPD (1) |
| >9 (8) | Age > 60 y (2) |
| Current or recent smoker | Reexploration (5) |
| No (0) | Operative duration > 300 min (1) |
| Yes (2) | Previous cardiac operation >6 mo (−1) |
| PVD | |
| No (0) | |
| Yes (3) | |
| Creatinine | |
| ≤1.2 (0) | |
| >1.2 (1) | |
| Score interpretation: | Score interpretation: |
| 0–7: Minimal risk | 0–4: Low risk |
| → Standard closure (wires) | Single wires |
| 8–10: Low risk | 5–7: Intermediate risk (<1%) |
| → Standard closure with incisional wound VAC | Special wiring method |
| 11–13: Intermediate risk | 8–10: High risk (<5%) |
| → Incisional wound VAC + enhanced closure (SRPF) at clinician’s discretion if: | Wires + bands or SRPF |
| • Mechanical concerns (eg, macromastia, morbid obesity, barrel chest) | 11–13: Very high risk (<15%) |
| • Poor bone quality | SRPF |
| 14–25: High risk | 14–18: Extremely high risk (<30%) |
| → Incisional wound VAC + strongly consider enhanced closure (SRPF) | SRPF |
Both scores provide risk categories with corresponding recommended interventions.
HbA1c, hemoglobin A1c; VAC, vacuum-assisted closure.