Infection Risk and Speed of Recovery in Small-Incision Operations

One of the most frequently asked questions after heart surgery is how the wound will heal and how great the risk of infection is. In this article I will explain the real data on these two issues for small-incision (minimally invasive) operations.

Rapid Recovery Because Bone Integrity Is Preserved

While healing of the breastbone that is cut in classic surgery takes 6-8 weeks, in small-incision techniques the bone is not touched at all, so this waiting period disappears completely. While our patients wait for the soft tissue incision made between the ribs to heal, they can return to their daily activities much earlier, usually within 2-3 weeks.

Wound Infection Rates

Large meta-analyses show that in valve operations performed through a small incision the rates of superficial and deep wound infection are significantly lower than with classic sternotomy; the main reasons for this are that the incision is smaller and that the bone tissue (one of the tissue types most prone to infection) is not opened at all. Deep sternal infection (mediastinitis), a rare but serious complication of classic operations, is almost never seen with small-incision techniques.

When Can I Take a Bath?

Once the wound has closed completely and we are sure there is no discharge, we usually allow showering 7-10 days after surgery; we recommend avoiding rubbing the wound directly and staying in water for long periods (bathtub, thermal spa) for the first few weeks. The exact timing is determined according to how the wound looks at the follow-up examination.

Frequently Asked Questions

Does a small incision always carry a lower risk of infection? The general tendency is in this direction, but individual risk factors such as diabetes and obesity affect the risk of infection with both techniques.

When are the sutures removed? Most modern techniques use subcutaneous, self-dissolving sutures; for this reason a separate suture-removal procedure is usually not needed.

What should I do if I see redness at the wound site? If you notice redness, increasing pain, discharge or fever, we recommend that you contact us without losing time.

Conclusion

Because the bone tissue is not touched, small-incision techniques offer both a faster recovery and a lower risk of infection. Our individual recommendations on wound care are shaped by the condition of the wound at your follow-up examinations.

You can make an appointment for anything you would like to know about your wound healing process.

References

1. Loop FD, Lytle BW, Cosgrove DM, et al. Sternal Wound Complications After Isolated Coronary Artery Bypass Grafting: Early and Late Mortality, Morbidity, and Cost of Care. Ann Thorac Surg. 1990;49(2):179-186.
2. Cao C, Gupta S, Chandrakumar D, et al. A Meta-Analysis of Minimally Invasive Versus Conventional Mitral Valve Repair for Patients with Degenerative Mitral Disease. Ann Cardiothorac Surg. 2013;2(6):693-703.