Initial Report of a New Suture Cerclage Tape for Sternal Closure

Abstract

PURPOSE: We sought to evaluate a new, flexible suture cerclage tape for sternal closure after cardiac surgery. DESCRIPTION: Fiber Tape (Arthrex, Naples, FL, USA) suture cerclage has been successfully utilized in the stabilization of long bone fractures. For sternal closure, it is placed similarly to wire cerclage. Uniquely, it allows a measurable amount of tension to be applied to the sternum and it is at least twice as strong as stainless steel wire. We hypothesized this new flexible tape would provide short term safety and efficacy, as measured by incidence of deep sternal wound infection. EVALUATION: We performed a retrospective, single center analysis of adult patients undergoing sternotomy closure with FT. The observed incidence of deep sternal wound infection (DSWI) was compared to the expected incidence calculated through the Society of Thoracic Surgery (STS) risk calculator. A total of 45 patients were closed with FT. No patients suffered DSWI. Thirty of the 45 patients had STS risk calculations. For these 30 patients, the expected rate of DSWI was 0.2%. CONCLUSIONS: Despite study limitations, FT appears to be a safe method for sternal closure.

Biomechanical comparison of canine median sternotomy closure using suture tape and orthopedic wire cerclage

“…In vitro, multifilament sutures have greater bacterial adherence than monofilament sutures. 35,36 However, clinical infection rates reported with multifilament sutures are low, and similar to comparable fixation techniques 19,33,34,37 …”

“…Suture tape is an alternative fixation technique used in humans for median sternotomy closure. 18,19 Suture tape is comprised of a 2 mm wide nonabsorbable multistrand, long-chain, ultrahigh-molecular-weight polyethylene core with a braided jacket of polyester. Advantages of suture tape versus metallic cerclage include ease of handling with the elimination of wire-stick injuries, less regional trauma, and radiolucency.…”

“…35,36 However, clinical infection rates reported with multifilament sutures are low, and similar to comparable fixation techniques. 19,33,34,37 The purpose of this study was to compare the mechanical properties of suture tape with orthopedic wire cerclage in an ex vivo canine median sternotomy model. We hypothesized that the suture tape would be mechanically similar to orthopedic wire when applied to a median sternotomy stabilization model in the dog.…”

“…Suture tape is an alternative fixation technique used in humans for median sternotomy closure 18,19 . Suture tape is comprised of a 2 mm wide nonabsorbable multistrand, long‐chain, ultrahigh‐molecular‐weight polyethylene core with a braided jacket of polyester.…”