Skip to main content

Advertisement

SpringerLink
Log in

Corpus Sterni Reinforcement Improves the Stability of Primary Sternal Closure in High-Risk Patients

  • Published:
Surgery Today Aims and scope Submit manuscript

Abstract

Purpose

To compare standard sternal closure techniques with reinforcement longitudinal wire placement in the corpus sterni in high-risk patients undergoing open-heart surgery via median sternotomy.

Methods

The subjects of this study were 71 high-risk patients, 32 (45%) of whom underwent sternal closure by conventional methods (group 1) and 39 (55%) of whom underwent sternal closure with corpus sterni reinforcement. The patients were followed up for a mean period of 90 days.

Results

In group 2, none of the patients had sternal dehiscence and no revision was required, but in group 1, five (15.5%) patients had sternal dehiscence. This difference was significant between the groups (P = 0.024), but there were no significant differences in mediastinitis and mortality (P > 0.05).

Conclusions

Our findings suggest that primary sternal closure with longitudinal wire reinforcement on both sides of the corpus sterni will decrease the risk of infection and improve wound-healing in parallel with a decrease in sternal dehiscence.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. DH Song RF Lohman JD Renucci V Jeevanandam J Raman (2004) ArticleTitlePrimary sternal plating in high-risk patients prevents mediastinitis Eur J Cardiothorac Surg 26 367–72 Occurrence Handle15296898 Occurrence Handle10.1016/j.ejcts.2004.04.038

    Article  PubMed  Google Scholar 

  2. I Pasaoglu S Arsan AC Yorgancioglu AY Bozer (1995) ArticleTitleA simple management of mediastinitis Int Surg 80 239–41 Occurrence Handle8775611 Occurrence Handle1:STN:280:DyaK28zntFOrug%3D%3D

    PubMed  CAS  Google Scholar 

  3. A Zacharias RH Habib (1996) ArticleTitleFactors predisposing to median sternotomy infection. Deep vs. superficial infection Chest 110 1173–8 Occurrence Handle8915216 Occurrence Handle1:STN:280:DyaK2s%2Fnt1Cmsg%3D%3D

    PubMed  CAS  Google Scholar 

  4. PE Antunes JE Bernardo L Eugenio JF de Oliveira MJ Antunes (1997) ArticleTitleMediastinitis after aortocoronary bypass surgery Eur J Cardiothorac Surg 12 443–9 Occurrence Handle9332924 Occurrence Handle10.1016/S1010-7940(97)00179-6 Occurrence Handle1:STN:280:DyaK2svnsVSrsA%3D%3D

    Article  PubMed  CAS  Google Scholar 

  5. A El Gamel NA Yonan R Hassan MT Jones CS Campbell AK Deiraniya et al. (1998) ArticleTitleTreatment of mediastinitis: early modified Robicsek closure and pectoralis major advencement flaps Ann Thorac Surg 65 41–7 Occurrence Handle9456093 Occurrence Handle10.1016/S0003-4975(97)01063-1 Occurrence Handle1:STN:280:DyaK1c7hsFKhug%3D%3D

    Article  PubMed  CAS  Google Scholar 

  6. RJ Baskett CE MacDaugall DB Ross (1999) ArticleTitleIs mediastinitis a preventable complication? A 10-year review Ann Thorac Surg 67 462–5 Occurrence Handle10197671 Occurrence Handle10.1016/S0003-4975(98)01195-3 Occurrence Handle1:STN:280:DyaK1M3htFGhug%3D%3D

    Article  PubMed  CAS  Google Scholar 

  7. G Tavilla JAM Van son F Verhagen LK Lacquet (1991) ArticleTitleModified Robicsek technique for complicated sternal closure Ann Thorac Surg 52 1179–80 Occurrence Handle1953149 Occurrence Handle1:STN:280:DyaK38%2FmtFejsg%3D%3D Occurrence Handle10.1016/0003-4975(91)91310-R

    Article  PubMed  CAS  Google Scholar 

  8. FD Loop BW Lytle DM Cosgrove S Mahfood MC Mc Henry M Goormastic et al. (1990) ArticleTitleSternal wound complications after isolated coronary artery bypass grafting: early and late mortality, morbidity, and cost of care Ann Thorac Surg 49 179–87 Occurrence Handle2306138 Occurrence Handle1:STN:280:DyaK3c7msFGnuw%3D%3D Occurrence Handle10.1016/0003-4975(90)90136-T

    Article  PubMed  CAS  Google Scholar 

  9. JF Gummert MJ Barten C Hans M Kluge N Doll T Walther et al. (2002) ArticleTitleMediastinitis and cardiac surgery-an updated risk factor analysis in 10,373 consecutive adult patients Thorac Cardiovasc Surg 50 87–91 Occurrence Handle11981708 Occurrence Handle10.1055/s-2002-26691 Occurrence Handle1:STN:280:DC%2BD383ktlKmsQ%3D%3D

    Article  PubMed  CAS  Google Scholar 

  10. T Krabatsch E Fleck R Hetzer (1995) ArticleTitleTreating poststernotomy mediastinitis by transposition of the greater omentum: late angiographic findings J Card Surg 10 46–51 Occurrence Handle7696789 Occurrence Handle1:STN:280:DyaK2M3htVygsg%3D%3D

    PubMed  CAS  Google Scholar 

  11. LM Gosolow JD Wagner M Felley T Sharp R Havlik R Sood et al. (1999) ArticleTitleRisk factors for predicting surgical salvage of sternal wound-healing complications Ann Plast Surg 43 30–5 Occurrence Handle10.1097/00000637-199907000-00005

    Article  Google Scholar 

  12. R Astudillo J Vaage U Myhre A Karevold B Gardlund (2001) ArticleTitleFewer reoperations and shorter stay in the cardiac surgical ward when stabilizing the sternum with the Ley prosthesis in post-operative mediastinitis Eur J Cardiothorac Surg 20 133–9 Occurrence Handle11423286 Occurrence Handle10.1016/S1010-7940(01)00755-2 Occurrence Handle1:STN:280:DC%2BD3Mzmt1Whtg%3D%3D

    Article  PubMed  CAS  Google Scholar 

  13. F Robicsek HK Daugherty JW Cook (1977) ArticleTitleThe prevention and treatment of sternum separation following open-heart surgery J Thorac Cardiovasc Surg 73 267–8 Occurrence Handle319304 Occurrence Handle1:STN:280:DyaE2s%2FpvVOgtQ%3D%3D

    PubMed  CAS  Google Scholar 

  14. UK Dasika DR Trumble JA Magovern (2003) ArticleTitleLower sternal reinforcement improves the stability of sternal closure Ann Thorac Surg 75 1618–21 Occurrence Handle12735589 Occurrence Handle10.1016/S0003-4975(02)04988-3

    Article  PubMed  Google Scholar 

  15. CC Shih CM Shih YY Su SJ Lin (2004) ArticleTitlePotential risk of sternal wires Eur J Cardiothorac Surg 25 812–8 Occurrence Handle15082287 Occurrence Handle10.1016/j.ejcts.2003.11.043

    Article  PubMed  Google Scholar 

  16. R El Oakley E Paul PS Wong A Yohana P Magee R Walesby et al. (1997) ArticleTitleMediastinitis in patient undergoing cardiopulmonary bypass: risk analysis and midterm results J Cardiovasc Surg 38 595–600 Occurrence Handle1:STN:280:DyaK1c7itFWlsA%3D%3D

    CAS  Google Scholar 

  17. CY Bitkover B Gardlund (1998) ArticleTitleMediastinitis after cardiovascular operations: a case-control study of risk factors Ann Thorac Surg 65 36–40 Occurrence Handle9456092 Occurrence Handle10.1016/S0003-4975(97)01003-5 Occurrence Handle1:STN:280:DyaK1c7hsFKhtQ%3D%3D

    Article  PubMed  CAS  Google Scholar 

  18. RF Di Marco SuffixJr M Lee S Bekoe KJ Grant GF Woelfel RF Pellegrini (1989) ArticleTitleInterlocking figure-of-eight closure of the sternum Ann Thorac Surg 47 927–9 Occurrence Handle2667479 Occurrence Handle10.1016/0003-4975(89)90042-8

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Cardiovascular Surgery, School of Medicine, Gazi University, Kalp ve Damar Cerrahisi AD, Beşevler, 06500, Ankara, Turkey

    Erkan Iriz, Dilek Erer, Pinar Koksal, Mehmet Emin Ozdogan, Velit Halit, Volkan Sinci, Levent Gokgoz & Ali Yener

Authors
  1. Erkan Iriz
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Dilek Erer
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Pinar Koksal
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Mehmet Emin Ozdogan
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Velit Halit
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Volkan Sinci
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Levent Gokgoz
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Ali Yener
    View author publications

    You can also search for this author in PubMed Google Scholar

Rights and permissions

Reprints and permissions

About this article

Cite this article

Iriz, E., Erer, D., Koksal, P. et al. Corpus Sterni Reinforcement Improves the Stability of Primary Sternal Closure in High-Risk Patients. Surg Today 37, 197–201 (2007). https://doi.org/10.1007/s00595-006-3376-5

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00595-006-3376-5

Key words

Search

Navigation