Sternal Bands for Closure of Midline Sternotomy Leads to Better Wound Healing

Bhattacharya, Susmit; Sau, Indrajit; Mohan, M Chandra; Hazari, Kunal; Basu, Rajarshi; Kaul, Ajay

doi:10.1177/021849230701500113

Cited by 14 publications

(11 citation statements)

References 19 publications

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“…As a result, the wires have been associated with various wound complications such as sternal dehiscence and mediastinitis. Mediastinitis has occurred in 0.4-3.8% patients after cardiac surgery (1)(2)(3)(4)9), which led to considerable morbidity and mortality in 14-47% of the patients in one study (15). These problems are often preceded by sternal instability.…”

Section: Discussionmentioning

confidence: 99%

“…These removals occurred more frequently in male than female patients. Bhattacharya et al (9) noted that male sex was a risk factor for sternal wound dehiscence. This finding is consistent with the results of our study.…”

Section: Discussionmentioning

confidence: 99%

“…The first report of using bands for sternal closure came from the University of New York at Stony Brook Hospital (8). Since then, many kinds of steel bands have been used with theoretical advantages over conventional wire closure (9)(10)(11)(12)(13).…”

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confidence: 99%

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Midterm Results of Sternal Band Closure in Open Heart Surgery and Risk Analysis of Sternal Band Removal

et al. 2015

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Sternal dehiscence, which is responsible for the development of mediastinitis, is a serious complication after cardiothoracic surgery. We retrospectively compared the results of two methods for sternal closure after cardiothoracic surgery performed during January 2009 to May 2012. The methods comprised closure with sternal bands and steel wires (group A, n = 92) versus conventional closure using steel wires alone (group B, n = 442). Although not significantly different between the two groups, no patients undergoing sternal band closure experienced dehiscence or mediastinitis. The incidence of having to remove materials used for sternal closure was significantly higher in group A than in group B. In each case of removal in group A, the materials removed were sternal bands whose tips had caused direct cutaneous irritation. Thus, although sternal bands may be effective for rigid sternal closure, they must sometimes be removed because of chest discomfort caused by the tip of the band.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Midterm Results of Sternal Band Closure in Open Heart Surgery and Risk Analysis of Sternal Band Removal

et al. 2015

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“…A similar approach has been ventured by Sterna-Band TM . Compared with wires, these steel bands not only provided effective fixation, they demonstrated a reduction in postoperative pain and length of postoperative hospital stay [7,8]. The advantages of the ZipFix TM over the Sterna-Band TM are the ease and speed of implantation and the reproducible tension of 200 N for each ZipFix TM .…”

Section: Discussionmentioning

confidence: 99%

A new cable-tie based sternal closure system: description of the device, technique of implantation and first clinical evaluation

Grapow

Melly

Eckstein

et al. 2012

J Cardiothorac Surg

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BackgroundWire closure still remains the preferred technique despite reasonable disadvantages. Associated complications, such as infection and sternal instability, cause time- and cost-consuming therapies. We present a new tool for sternal closure with its first clinical experience and results.MethodsThe sternal ZipFixTM System is based on the cable-tie principle. It primarily consists of biocompatible Poly-Ether-Ether-Ketone implants and is predominantly used peristernally through the intercostal space. The system provides a large implant-to-bone contact for better force distribution and for avoiding bone cut through.Results50 patients were closed with the ZipFixTM system. No sternal instability was observed at 30 days. Two patients developed a mediastinitis that necessitated the removal of the device; however, the ZipFixTM were intact and the sternum remained stable.ConclusionsIn our initial evaluation, the short-term results have shown that the sternal ZipFixTM can be used safely and effectively. It is fast, easy to use and serves as a potential alternative for traditional wire closure.

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“…It is well known that an inadequate sternal closure leads to a sternal instability [5]. Therefore, diverse techniques have been devised to reduce sternal instability [6][7][8][9][10], but a final solution has not been found yet.…”

Section: Introductionmentioning

confidence: 99%

The number of wires for sternal closure has a significant influence on sternal complications in high risk patients

Al-maisary¹,

Kamiya²,

Akhyari³

et al. 2009

Thorac cardiovasc Surg

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OBJECTIVES: Sternal dehiscence and mediastinitis are rare but serious complications following cardiac surgery. The aim of this study was to investigate the influence of the number of sternal wires used for chest closure on sternal complications. RESULTS: Sternal complications occurred in 2.4%, and hospital mortality with or without sternal complications were 2.8 and 2.7%, respectively (P = 0.60). Mean numbers of sternal wires were 7.8 in both patient groups with or without sternal complications (P = 0.79). Multivariate analysis revealed diabetes mellitus [odds ratio (OR) 1.54, 95% CI 1.01-2.34, P = 0.04], chronic obstructive pulmonary disease (OR 1.85, 95% CI 1.12-2.79, P = 0.01) and renal insufficiency (OR 1.70, 95% CI 1.11-2.59, P = 0.001) as significant risk factors for sternal complications. In high-risk patients, the use of less than eight wires was significantly associated with postoperative sternal complications.CONCLUSIONS: Particularly in high-risk patients, careful haemostasis should be done and eight or more wires should be used to avoid sternal complications.

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Sternal Bands for Closure of Midline Sternotomy Leads to Better Wound Healing

Cited by 14 publications

References 19 publications

Midterm Results of Sternal Band Closure in Open Heart Surgery and Risk Analysis of Sternal Band Removal

Midterm Results of Sternal Band Closure in Open Heart Surgery and Risk Analysis of Sternal Band Removal

A new cable-tie based sternal closure system: description of the device, technique of implantation and first clinical evaluation

The number of wires for sternal closure has a significant influence on sternal complications in high risk patients

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