Abstract
Background Stainless steel wires are still commonly used as a sternum closure technique. However, it can cause fatal complications due to rupture and dehiscence. It was anticipated that the sternal Cable System (Pioneer Surgical Technology Inc., Marquette, MI, USA) could provide a better sternal fixation and reduce the possible complications. Materials and Method. A total of 100 patients (57 male, 43 female) at high risk of dehiscence were included in this prospective observational study. Among those with EuroSCORE value of 4 and above, patients with chronic lung disease, chronic kidney disease, diabetes mellitus, obesity, smoking, body mass index, advanced age, and resurgery were operated in two separate centers. Standard steel wires (n: 51) used for sternotomy were compared with the sternal cable (n: 49). Early and late sternal dehiscence rates were compared in the study. The relationship between risk factors causing dehiscence and both methods was assessed statistically. Results Early dehiscence rates were 6.4% in those closed with a sternal cable (n: 3) and 11.8% in those closed with a sternal wire (n: 6) (p < 0.05)). In risky patients, body mass index was the most determining parameter in terms of sternum dehiscence risk. Conclusion In risky patients, we recommend the sternal cable system as a good and reliable closure technique to achieve a more stable and compact sternum.
Highlights
Median sternotomy still continues to be the most common incision type in open heart surgery as an easy, safe, fast, and inexpensive method
When both sternum closure techniques are compared, early dehiscence rates were 6.4% in cases closed with sternal cable and 11.8% in cases closed with sternal wire (p < 0:05) (Table 2)
Hospitalization durations and drainage rates were found to be higher in patients who were closed with a sternal cable (p < 0:05) (Table 4)
Summary
Median sternotomy still continues to be the most common incision type in open heart surgery as an easy, safe, fast, and inexpensive method. If adequate sternal closure could not be provided, complications can be fatal especially in patients with advanced age and comorbidities. It is important because of the high risk of sternal complications due to advanced age, chronic obstructive pulmonary disease (COPD), diabetes mellitus (DM), chronic renal failure (CRF), obesity, and osteoporosis. A total of 100 patients (57 male, 43 female) at high risk of dehiscence were included in this prospective observational study. Among those with EuroSCORE value of 4 and above, patients with chronic lung disease, chronic kidney disease, diabetes mellitus, obesity, smoking, body mass index, advanced age, and resurgery were operated in two separate centers. We recommend the sternal cable system as a good and reliable closure technique to achieve a more stable and compact sternum
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