The Simple Technique of Sternal Closure Using An Absorbable Mesh Plate

Watanuki, Hirotaka; Futamura, Yasuhiro; Tochii, Masato; Sugiyama, Kayo; Matsuyama, Katsuhiko

doi:10.1532/hsf.4443

Cited by 2 publications

(2 citation statements)

References 11 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…1, we devised this method assuming that sandwiching the sternum between the plates would prevent sternal displacement and postoperative bleeding by tightly aligning the sternal bone marrow. Axial CT evaluation on postoperative day 5 showed a signi cantly less sternal step-off and less postoperative substernal hematoma formation in group M than in group P (Table 4), which was similar to the study by Watanuki et al who reported less anteroposterior sternal displacement [14]. In our multivariate analysis of postoperative CT data for substernal hematoma, the mesh plate was an independent predictor of substernal hematoma prevention.…”

Section: Discussionsupporting

confidence: 89%

Sternal closure with sandwiched three-piece bioresorbable mesh reduces postoperative hemorrhage: a retrospective study

Yokoyama

Yamamoto

Oyama³

et al. 2023

Preprint

View full text Add to dashboard Cite

Background: Median sternotomy is the most performed procedure in cardiac surgery; however, sternal bleeding remains a problem. This study aimed to investigate whether sternal reconstruction using a sandwiched three-piece bioresorbable mesh plate can prevent postoperative bleeding more than a bioresorbable pin. Methods: Patients (n = 218) who underwent median sternotomy were classified according to whether a sandwiched three-piece bioresorbable mesh plate and wire cerclage (group M, n = 109) or a bioresorbable pin and wire cerclage (group P, n = 109) was used during sternal reconstruction. The causes of postoperative bleeding and computed tomography data were analyzed and compared between the groups. Results: The preoperative patient characteristics did not significantly differ between the groups. However, the amount of bleeding at 6 h postoperatively was lower in group M than in group P (235 ± 147 vs. 284 ± 175 mL, p = 0.0275). Chest reopening, intubation time, and length of intensive care unit and hospital stays did not differ between the groups. Evaluation for sternal and substernal hematoma on postoperative day 5 using computed tomography showed sternal displacement in 4 (4%) and 22 (20%) patients, and substernal hematoma in 9 (8%) and 22 (20%) patients in groups M and P, respectively; the difference was significant. The four-grade evaluation of substernal hematoma based on computed tomography yielded a significantly lower grade for group M than for group P, revealing that the mesh plate was an independent predictor of substernal hematoma prevention. Conclusion: Sternal fixation with a three-piece bioresorbable mesh plate could prevent postoperative bleeding and substernal hematoma more than sternal fixation with a pin.

show abstract

Section: Discussionsupporting

confidence: 89%

Sternal closure with sandwiched three-piece bioresorbable mesh reduces postoperative hemorrhage: a retrospective study

Yokoyama

Yamamoto

Oyama³

et al. 2023

Preprint

View full text Add to dashboard Cite

show abstract

“…1 , we devised this method assuming that sandwiching the sternum between the plates would prevent sternal displacement and postoperative bleeding by tightly aligning the sternal bone marrow. Axial CT evaluation on postoperative day 5 showed a significantly less sternal step-off and less postoperative substernal hematoma formation in group M than in group P (Table 4 ), which was similar to the study by Watanuki et al who reported less anteroposterior sternal displacement [ 13 ]. In our multivariate analysis of postoperative CT data for substernal hematoma, the mesh plate was an independent predictor of substernal hematoma prevention.…”

Section: Discussionsupporting

confidence: 88%

Sternal closure with sandwiched three-piece bioresorbable mesh reduces postoperative hemorrhage: a retrospective study

Yokoyama,

Yamamoto,

Oyama

et al. 2023

J Cardiothorac Surg

View full text Add to dashboard Cite

Background Median sternotomy is the most performed procedure in cardiac surgery; however, sternal displacement and bleeding remains a problem. This study aimed to investigate whether sternal reconstruction using a sandwiched three-piece bioresorbable mesh plate can prevent postoperative sternal displacement and bleeding more than a bioresorbable pin. Methods Patients (n = 218) who underwent median sternotomy were classified according to whether a sandwiched three-piece bioresorbable mesh plate and wire cerclage (group M, n = 109) or a bioresorbable pin and wire cerclage (group P, n = 109) were used during sternal reconstruction. The causes of postoperative sternal displacement and bleeding with computed tomography data were analyzed and compared between the groups. Results The preoperative patient characteristics did not significantly differ between the groups. However, the evaluation of sternal and substernal hematoma on postoperative day 5 using computed tomography showed sternal displacement in 4 (4%) and 22 (20%) patients, and substernal hematoma in 17 (16%) and 41 (38%) patients in groups M and P, respectively; this difference was significant. Furthermore, the amount of bleeding at 6 h postoperatively was lower in group M than in group P (235 ± 147 vs. 284 ± 175 mL, p = 0.0275). Chest reopening, intubation time, and length of intensive care unit and hospital stays did not differ between the groups. The evaluation of substernal hematoma based on computed tomography yielded a significantly lower for group M than for group P, revealing that the mesh plate was an independent predictor of substernal hematoma prevention. Conclusion Sternal fixation with a three-piece bioresorbable mesh plate could prevent postoperative sternal displacement, bleeding, and substernal hematoma more than sternal fixation with a pin.

show abstract

The Simple Technique of Sternal Closure Using An Absorbable Mesh Plate

Cited by 2 publications

References 11 publications

Sternal closure with sandwiched three-piece bioresorbable mesh reduces postoperative hemorrhage: a retrospective study

Sternal closure with sandwiched three-piece bioresorbable mesh reduces postoperative hemorrhage: a retrospective study

Sternal closure with sandwiched three-piece bioresorbable mesh reduces postoperative hemorrhage: a retrospective study

Contact Info

Product

Resources

About