The transverse submammary skin incision for median sternotomy

Median sternotomy is the incision of choice to allow access to the anterior mediastinum, heart or both lungs. The vertical skin incision is cosmetically unsatisfactory for many female patients. The transverse submammary skin incision with dissection of a flap including the subcutaneous tissue and breasts allow exposure of the sternum for a median sternotomy. Seventy patients with the transverse submammary skin incision was compared with 56 patients with the vertical skin incision in the point of the cosmetic aspect and satisfaction of patients. The transverse submammary skin incision needed a longer wound size and took a longer time for cardiopulmonary bypass, but there were no difficulties in cannulating the ascending aorta for cardiopulmonary bypass. The exposure of the mediastinum and the cosmetic result were excellent. The complications associated with this incision are insignificant if close attention is paid to details.