Abstract
Median sternotomy is the most commonly used and the standard way of an incision after cardiothoracic procedures. The use of stainless steel wire has been considered the gold standard in the sternal closure system; however, increasing postoperative complications have caused other options. The aim of this study is to understand the combined effect of the ZipFix bands with steel wires on postoperative outcomes after sternal closure. This is a real-world evidence study of patients treated using the ZipFix band and steel wires. The sternal closure is performed by fixing of manubrium with straight simple wires, followed with ZipFix 3 or 4 spaces. Demographic characters of patients using the ZipFix band and steel wire and their relation to sternal infections, wound dehiscence, and post-surgical outcomes are studied. From gathered evidence, 2% of patients’ cases were complicated with the incidence of sternal infections. Ninety-nine percentage of patients had a stable and healthy wound while 1% of patients showed sternal wound dehiscence. The mean duration of hospital and intensive care unit stay was 8.53 (± 4.84) days and 3.58 (± 5.01) days respectively. The use of the sternal ZipFix system in combination with stainless steel wire is found to be effective in reducing post-surgical complications.
Highlights
Accelerated rise in cardiac diseases due to an increase in life expectancy has caused a rise in the minimally invasive methods in open-heart surgery. [1] Median sternotomy is the standard way of an incision after cardiothoracic procedures and the preferred technique owing to its low incidence of complications and less painful nature
They had undergone the sternal closure with stainless steel (SS) wires and ZipFix cable wires
The mean body mass index (BMI) was 27.81 (SD: 5.61 kg/m2). Preoperative variables such as ejection fraction (EF) and logistic euro score were recorded for each patient and the mean is mentioned in table 1
Summary
Accelerated rise in cardiac diseases due to an increase in life expectancy has caused a rise in the minimally invasive methods in open-heart surgery. [1] Median sternotomy is the standard way of an incision after cardiothoracic procedures and the preferred technique owing to its low incidence of complications and less painful nature. A few innovations in closure techniques are attempted over the period such as reinforced wires, sternum cable, and plating. They are developed to minimize the risk of non-union, provide sternal stability, especially in high-risk patients. [2] Various studies have reported the use of sternal ZipFix has decreased post-surgical complications such as sternal dehiscence and SWI and provided stability to the sternum. Post-surgical outcomes, the major concern in using SS wires can be managed with the use of a cable tie sternum closure system along with SS wires. [8] This study collates the evidence of the effects of the ZipFix system along with SS wire on post-surgical complications such as sternal infections and wound complications As reported by Stelly et al, the use of cable ties may reduce the risk of DSWI compared to wire sutures alone. [8] This study collates the evidence of the effects of the ZipFix system along with SS wire on post-surgical complications such as sternal infections and wound complications
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