Persistent post sternotomy chest pain: Does sternal wire removal have a role?

Abstract

BackgroundPersistent post sternotomy pain is a disabling phenomenon and its cause is unclear. It may be related to hypersensitivity reaction to wire, scar entrapped neuralgia, sternal irritation, chondritis or protruding wires. We aimed to evaluate the effectiveness of sternal wire removal on poststernotomy pain relief. MethodsIt is a retrospective study conducted on 48 patients who underwent removal of sternal wires due to persistent post sternotomy anterior chest pain. All wires were removed after exclusion of myocardial ischemia, sternal instability and wound infection. Patients were followed up after 3 months and were divided into 3 groups according to pain response: complete improvement, partial improvement and no improvement. ResultsThe mean age of patients involved in the study was 39.77 ± 9.44. 66.7% of patients were males. 72.9 %underwent valve surgery. Time lag between primary operation and removal of wires was 23.65 ± 9.26 months. No patients had history of allergy. Regarding response to treatment, patients were asked 3 months after operation about pain relief: 64.6% of patients showed complete improvement, 22.9% had improvement with minimal symptoms, 12.5% showed no improvement thus there was significant improvement in 87.5% of cases. ConclusionsRemoval of sternal wires is safe, simple and effective procedure that should be offered to patients with persistent post sternotomy chest pain after exclusion of myocardial ischemia, wound infection and sternal instability.