Abstract
This study investigates the use of gallium (Ga) based glass polyalkenoate cements (GPCs) as a possible alternative adhesive in sternal fixation, post sternotomy surgery. The glass series consists of a Control (CaO–ZnO–SiO2), and LGa-1 and LGa-2 which contain Ga at the expense of zinc (Zn) in 0.08 mol% increments. The additions of Ga resulted in increased working time (75 s to 137 s) and setting time (113 to 254 s). Fourier Transform Infrared (FTIR) analysis indicated that this was a direct result of increased unreacted poly(acrylic acid) (PAA) and the reduction of crosslink formation during cement maturation. LGa samples (0.16 wt % Ga) resulted in an altered ion release profile, particularly for 30 days analysis, with maximum Ca2+, Zn2+, Si4+ and Ga3+ ions released into the distilled water. The additions of Ga resulted in increased roughness and decreased contact angles during cement maturation. The presence of Ga has a positive effect on the compressive strength of the samples with strengths increasing over 10 MPa at 7 days analysis compared to the 1 day results. The additions of Ga had relatively no effect on the flexural strength. Tensile testing of bovine sterna proved that the LGa samples (0.16 wt % Ga) are comparable to the Control samples.
Highlights
Sternotomy and sternal closure occur before and after cardiac surgery, respectively
Post-operative complications such as instability, deep sternal wound infection (DSWI) and non-union are associated with poor sternal fixation resulting in mortality, morbidity and resource utilization [4,5,6,7,8,9,10,11,12,13]
Alhalawani and Towler suggested the ideal characteristics for a sternal closure device in order to contribute to reduced post-operative complications; these characteristics include a device with mechanical properties suited to the local environment, biocompatibility, radio-opacity, cost-effectiveness and ease-of-removal when necessary
Summary
Sternotomy and sternal closure occur before and after cardiac surgery, respectively. Sternotomy is utilized during thoracic procedures such as open-heart, cardiac valve replacement and coronary bypass surgeries [1,2]. Kryptonite is, at present, the best choice of adhesive material for sternal closure; it still relies on the use of wires in the initial few hours, it does not work to combat the possible wound infection and it has been implicated as not providing any significant benefit to healing This initial study evaluates the potential of using a therapeutic, anti-bacterial, Ga-containing GPCs for sternal fixation by characterising a series of Ga-containing GPCs with respect to their applicability for sternotomy fixation and repair without the use of fixation wires.
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