Abstract
Sternal instability or dehiscence results in serious sternal wound infection. We sought to assess the early outcomes with such a plating system for sternal closure in comparison to the conventional wiring technique in off-pump coronary artery bypass grafting (CABG). Patients who underwent off-pump CABG were enrolled. Thirty-one patients received plate sternal fixation. A total of 64 patients who underwent off-pump CABG by a single surgeon at our hospital from July 2013 to December 2014 were enrolled. Thirty-one patients received plate sternal fixation (Plate group), while 33 received conventional wire closure (Wire group). The early outcomes, including the pain score and analgesic usage count were compared. Dietary intake was also recorded to assess the duration of appetite loss. At discharge, the largest sternal displacement was measured on computed tomography. In the Plate group, the pain scores were significantly lower on post-operative day 5–8 and POD 9–12 from those in the Wire group. The analgesic usage count on POD 9–12 was significantly lower in the Plate group. The duration of appetite loss and hospital stay was significantly shorter in the Plate group. The displacement in both the anterior–posterior and lateral directions was significantly smaller in the Plate group. Sternal closure by rigid plate fixation contributes to a more rapid post-operative recovery through reduced pain.
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References
Song DH, Lohman RF, Renucci JD, Jeevanandam V, Raman J. Primary sternal plating in high-risk patients prevents mediastinitis. Eur J Cardiothorac Surg. 2004;26:367–72.
Risnes I, Abdelnoor M, Almdahl SM, Svennevig JL. Mediastinitis after coronary artery bypass grafting risk factors and long-term survival. Ann Thorac Surg. 2010;89:1502–9.
Bottio T, Rizzoli G, Vida V, Casarotto D, Gerosa G. Double crisscross sternal wiring and chest wound infections: a prospective randomized study. J Thorac Cardiovasc Surg. 2003;126:1352–6.
Fu XM, Oshima H, Araki Y, Narita Y, Mutsuga M, Okada N, Tsunekawa T, Usui A. A comparative study of two types of sternal pins used for sternal closure: poly-l-lactide sternal pins versus uncalcined hydroxyapatite poly-l-lactide sternal pins. J Artif Organs. 2013;16:458–63.
Raman J, Straus D, Song DH. Rigid plate fixation of the sternum. Ann Thorac Surg. 2007;84:1056–8.
Snyder CW, Graham LA, Byers RE, Holman WL. Primary sternal plating to prevent sternal wound complications after cardiac surgery: early experience and patterns of failure. Interact Cardiovasc Thorac Surg. 2009;9:763–6.
Hirose H, Yamane K, Youdelman BA, Bogar L, Diehl JT. Rigid sternal fixation improves postoperative recovery. Open Cardiovasc Med J. 2011;5:148–52.
Sasseron AB, Figueiredo LC, Trova K, Cardoso AL, Lima NM, Olmos SC, Petrucci O. Does the pain disturb the respiratory function after open heart surgery? Rev Braz Cir Cardiovasc. 2009;24:490–6.
Pai S, Gunja NJ, Dupak EL, McMahon NL, Coburn JC, Lalikos JF, Dunn RM, Francalancia N, Pins GD, Billiar KL. A mechanical study of rigid plate configurations for sternal fixation. Ann Biomed Eng. 2007;35:808–16.
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Matsuyama, K., Kuinose, M., Koizumi, N. et al. Sternal closure by rigid plate fixation in off-pump coronary artery bypass grafting: a comparative study. J Artif Organs 19, 175–178 (2016). https://doi.org/10.1007/s10047-015-0870-9
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DOI: https://doi.org/10.1007/s10047-015-0870-9