Comparison of Two Sternal Closure Techniques Based on Risk Factors: A Prospective, Observational Study

Abstract

Background. Stainless steel wires are still commonly used as a sternum closure technique. However, it can cause fatal complications due to rupture and dehiscence. It was anticipated that the sternal Cable System (Pioneer Surgical Technology Inc., Marquette, MI, USA) could provide a better sternal fixation and reduce the possible complications. Materials and Method. A total of 100 patients (57 male, 43 female) at high risk of dehiscence were included in this prospective observational study. Among those with EuroSCORE value of 4 and above, patients with chronic lung disease, chronic kidney disease, diabetes mellitus, obesity, smoking, body mass index, advanced age, and resurgery were operated in two separate centers. Standard steel wires ( n : 51) used for sternotomy were compared with the sternal cable ( n : 49). Early and late sternal dehiscence rates were compared in the study. The relationship between risk factors causing dehiscence and both methods was assessed statistically. Results. Early dehiscence rates were 6.4% in those closed with a sternal cable ( n : 3) and 11.8% in those closed with a sternal wire ( n : 6) ( p < 0.05 )). In risky patients, body mass index was the most determining parameter in terms of sternum dehiscence risk. Conclusion. In risky patients, we recommend the sternal cable system as a good and reliable closure technique to achieve a more stable and compact sternum.

Analysis of Factors Influencing Thoracic Deformities after Median Sternotomy in Infants Who Underwent Congenital Cardiac Surgery

“…After median sternotomies in adults, studies of sternal dehiscence showed that BMI was also a signifcant predictor. Nevertheless, the efect of BMI in adults was refected in the negative efect of obesity [17]. Te study by Zura et al…”

Impact of local delivery of allogenic chondrocytes on the biological response andhealing of the sternum bones after sternotomy

“…In turn, mortality due to sternal instability used to reach 50%, but medical progress and the development of new technologies have contributed to a signi cant reduction to about 10%, which is still a serious problem (15)(16). In addition, the development of these complications is in uenced by many risk factors related to patient's comorbidities, such as obesity, osteoporosis, heart failure, as well as his lifestyle and the surgery performed (4,14,17).…”

Impact of local delivery of allogeneic chondrocytes on the biological response and healing of the sternum bones after sternotomy

“…In turn, mortality due to sternal instability used to reach 50%, but medical progress and the development of new technologies have contributed to a significant reduction to about 10%, which is still a serious problem 15 , 16 . In addition, the development of these complications is influenced by many risk factors associated with the patient's comorbidities, such as obesity, osteoporosis, heart failure, as well as his lifestyle and the surgery performed 4 , 14 , 17 .…”