Abstract
ObjectivesRecently a biocompatible bone adhesive was introduced in addition to the sternal wires to expedite sternal union and improve patient recovery. In this study we aim to objectively assess the biomarker of pain in patient who received the biocompatible bone adhesive.MethodsA total of 62 patients who underwent sternotomy were prospectively randomised to receive either conventional wire closure (CWC); 32 patients or adhesive enhanced closure in addition to sternal wire (AEC); 30 patients. Patients were monitored postoperatively at certain time intervals for incisional pain, serum Interleukin-6 (IL-6) level, analgesia used and postoperative complications. All patients were followed up for 4 weeks.ResultsThe post-operative pain scores with coughing were significantly higher in the CWC group at 24 hours and 48 hours. The postoperative IL 6 levels were significantly higher in the CWC group in comparison with the AEC group at 6 hours, 24 hours, and 48 hours. There were no significant differences in term of additional analgesia used. No adverse events from adhesive bone cement were observed during follow up.ConclusionsAdhesive-enhanced sternal closure resulted in modest reduction of pain confirmed by reduction of pain biomarker. Justification of its routine use requires larger multicentre study.
Highlights
Since its introduction in 1957 median sternotomy has been be the most popular incision to access the cardiac structures for open heart surgery [1]
Despite the recent advances in minimal access and robotic cardiac surgery, median sternotomy remains the incision of choice and will probably continue to be popular in the future [2,3]
There were no significant differences in the postoperative pain score between the two groups at all the specific interval
Summary
Since its introduction in 1957 median sternotomy has been be the most popular incision to access the cardiac structures for open heart surgery [1]. Despite the recent advances in minimal access and robotic cardiac surgery, median sternotomy remains the incision of choice and will probably continue to be popular in the future [2,3]. The complications from median sternotomy include acute and chronic pain, instability, non-union, malunion and infections [4,5]. Each of these complications can vary in severity and can be potentially fatal especially in the case of deep sternal wound infection [6].
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