Median sternotomy: Comparative testing of braided superelastic and monofilament stainless steel sternal sutures

Abstract

A new device to reduce the risk of post-operative complications following median sternotomy is proposed, made of a superelastic shape memory alloy and called a braided tubular superelastic (BTS) suture. This study compares the viability of the BTS suture with that of the standard monofilament stainless steel (MSS) suture. A custom test bench was developed to perform comparative testing of the two sternal closure systems. Sternal models made of polyurethane were closed using common wiring configurations. Static and dynamic tensile separation forces, up to a maximum of 1200 N, were then applied to the closed sternums. The MSS and BTS sutures are compared in terms of the force required to open completely the sternum, the compression force at the sternum midline, and the permanent sternum opening. With a smaller sternum opening and a higher tensile separation force, the MSS suture showed greater rigidity than the BTS suture. The BTS suture, however, displayed a better capacity to reapply compression forces at the sternum midline following the repetitive application and release of tensile separation forces. These results confirm the potential of the BTS suture technology, but further studies using cadaveric sterna are needed to attest definitely to the benefits of using the BTS suture to improve bone healing.