ZipFix Versus Conventional Sternal Closure: One-Year Follow-Up

Nezafati, Pouya; Shomali, Ali; Kahrom, Mahdi; Tehrani, Sahar Omidvar; Dianatkhah, Minoo; Nezafati, Mohammad Hassan

doi:10.1016/j.hlc.2018.01.010

Cited by 17 publications

(14 citation statements)

References 22 publications

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“…It was reported during follow-up based on diagnostic criteria that are consistent with guidelines outlined by the US Centers for Disease Control and Prevention Criteria. Secondary outcomes included any sternal wound infection, and pain rating scales as measured by the 11-point "visual analog scale" 2,9 or "the Modified Brief Pain Inventory Short Form." 5…”

Section: Discussionmentioning

confidence: 99%

“…All 3 studies adequately reported the outcomes needed; however, the sample sizes were small, which increases the risk of bias. 2,6,9 The duration of follow-up for the RCTs ranged from 1 to 16 months. All observational studies were retrospective and 3 of the 4 were unmatched.…”

Section: Description Of Selected Studies and Quality Assessmentmentioning

confidence: 99%

“…Median sternotomy remains the most commonly performed bone osteotomy, allowing for excellent exposure and quick access to the pericardial structures in patients undergoing cardiac surgery. [1][2][3] Wire cerclage (WC) remains the dominant form of sternal closure due to ease, familiarity, speed, and costeffectiveness. 2 However, in many other surgical specialties, rigid fixation with plates or devices is commonly used for bone fracture stabilization.…”

Section: Introductionmentioning

confidence: 99%

“…[1][2][3] Wire cerclage (WC) remains the dominant form of sternal closure due to ease, familiarity, speed, and costeffectiveness. 2 However, in many other surgical specialties, rigid fixation with plates or devices is commonly used for bone fracture stabilization. 4 Unlike other means of bone fixation, there is concern with WC regarding improper bone union and sternal instability, 5 which can lead to clinically important concerns such as sternal dehiscence.…”

Section: Introductionmentioning

confidence: 99%

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Wire Cerclage Versus Cable Closure After Sternotomy for Dehiscence and DSWI: A Systematic Review and Meta-Analysis

Dixit

Tam

et al. 2020

Innovations�(Phila)

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Objective Cable closure has been introduced as a potential alternative to traditional wire cerclage (WC) for closure of median sternotomy. To evaluate whether cable closure improves patient outcomes, we conducted a systematic review and meta-analysis of the literature. Methods Ovid versions of Medline and Embase, and Google Scholar were used for the literature search. This yielded 7 studies ( n = 2,758), which compared traditional WC to cable closure systems. Outcomes included deep sternal wound infection, sternal dehiscence, postoperative pain score, and sternal wound infection. Results We found significantly lower incidence of sternal dehiscence for cable closure compared to WC (risk ratio [RR] 0.14, 95% confidence interval [CI]: 0.03 to 0.59 , P < 0.01 , I 2 = 0%) but no difference in DSWI (RR 0.97, 95% CI: 0.39 to 2.42, P = 0.95, I 2 = 33%). Cable closure was also associated with lower pain when compared with the WC group (mean difference −1.04 points, 95% CI: −1.89 to −0.19 , P = 0.02, I 2 = 87%). Conclusions This study suggests that cable closure results in less incidence of sternal dehiscence and pain compared to WC. Nonetheless, there remains a limited number of studies on this topic and further high-quality studies are required to confirm the results of this meta-analysis.

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Section: Discussionmentioning

confidence: 99%

Section: Description Of Selected Studies and Quality Assessmentmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Wire Cerclage Versus Cable Closure After Sternotomy for Dehiscence and DSWI: A Systematic Review and Meta-Analysis

Dixit

Tam

et al. 2020

Innovations�(Phila)

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show abstract

“…The results of this study are strikingly different from those published by Nezafati and colleagues in Heart, Lung & Circulation. 2 In a RCT of 326 patients randomized to ZIPFIX or wire cerclage, the authors reported improved pain scores with ZIPFIX. More impressive, the authors reported a significant reduction in sternal dehiscence (0 in the ZIPFIX group and 5 in the wire group; P <.001).…”

Section: Cable Ties For Chest Closure: Zipfix or Zipfail? To The Editormentioning

confidence: 99%