Application of Titanium Plate Fixation in Sternal Dehiscence after Cardiac Surgery

Atay, Mehmet; Toz, Hasan; Açıkgöz, Burak; Türkyilmaz, Saygın; Kavala, Ali Aycan

doi:10.1016/j.amjcard.2018.03.083

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“…Similarly, Bejko et al found less deep sternal wound infection after the application of TRNCs compared with SSW (0.2% vs 1.6%; p=0.02). [15][16][17][18][19] They compared 1702 patients who had undergone a procedure with SSW and 572 patients with TRNCs and concluded that TRNCs were superior to SSW for sternal closure. In our study, 24.3% of the patients experienced a sternal wound infection after the application of TRNCs and 59.4% developed a sternal wound infection following the use of SSW.…”

Section: Discussionmentioning

confidence: 99%

Clinical results of nitinol plate implentation for reconstruction of sternal dehiscence

Apaydin¹

2021

South Clin Ist Euras

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Objective: Difficulties with sternal bone healing or infection after a median sternotomy performed for open cardiac surgery can result in significant morbidity and mortality. This study evaluates the efficacy, safety, advantages, disadvantages, and techniques related to the use of thermoreactive nitinol clips (TRNCs) to treat sternal dehiscence.Methods: TRNCs were used to close the sternum in 40 patients (26 male, 14 female; mean age: 60±4 years, range: 45-76 years) with sternal dehiscence that developed following primary cardiac surgery between July 2010 and February 2019. Sternum revision was performed at a mean of 72±4 days postoperative (range: 9-255 days). Vacuum-assisted closure (VAC) was applied before the surgical intervention in 55% (n=22) of the patients due to superficial wound infection.Results: Pleurisy was observed in 1 patient, and pneumonia developed in 1 patient after the revision. Mortality did not occur during hospitalization. The nitinol plates were removed in a second revision surgery in 9 patients: a pectoralis flap was created for 3, a reconstructive rectus flap was used in 1, and primary wound closure was implemented in 5 cases due to recurrent wound infection. Mortality was recorded in 1 patient in the postoperative period. Sternotomy complications of recurrent sternal dehiscence, mediastinitis, sternal abscess, or secondary osteomyelitis were not observed in 6 months of follow-up. Conclusion:Surgical interventions for sternal dehiscence should optimally be performed in the early period to decrease the risk of dehiscence secondary to infection and mediastinitis. The use of TRNCs for patients with sternal dehiscence was successful and decreased the duration of hospital stay and the risk of postoperative complications, as well as providing greater patient comfort.

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Section: Discussionmentioning

confidence: 99%

Clinical results of nitinol plate implentation for reconstruction of sternal dehiscence

Apaydin¹

2021

South Clin Ist Euras

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Application of Titanium Plate Fixation in Sternal Dehiscence after Cardiac Surgery

Cited by 1 publication

References 0 publications

Clinical results of nitinol plate implentation for reconstruction of sternal dehiscence

Clinical results of nitinol plate implentation for reconstruction of sternal dehiscence

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