A Simple Modification of the Conventional Figure-of-Eight Sternal Closure Technique

Abstract

Objective To describe a new technique of sternal closure, modified from the conventional figure-of-eight approach, which can provide a secure closure and prevent sternal complications. Methods The modified technique is based on the intercalation of the caudal portion of each steel wire passed along the sternum. This is a retrospective analysis of patients operated with this modified technique at our institution between January 2014 and December 2016. Results One hundred and forty-three patients underwent sternal closure with the modified technique. In-hospital mortality rate was 1.4% (n=2). No sternal instability was observed at 30 days postoperatively. Two patients developed mediastinitis that required extraction of the wires. Conclusion Short-term results have shown that the modified sternal closure technique can be used safely and effectively, with complications rates being consistent with worldwide experience.

Review of Biomechanical Studies and Finite Element Modeling of Sternal Closure Using Bio-Active Adhesives

“…Effective and safe method for limiting sternal dehiscence by limiting the penetration in the intercostal spaces [40] Longitudinal parasternal…”

A Randomized Study Evaluating Clinical Efficacy and Safety of Trusteel® and Ethisteel® Surgical Steel Sutures for Sternal Closure in Subjects Undergoing Surgical Procedures by Sternotomy

“…Sternal integrity resumption following sternotomy for open heart surgery forms the basis for speedy recovery [ 4 ]. Sternotomy closure with wires has been the gold standard technique for more than 50 years as it is easily and quickly achievable, has a low complication rate, and is economical because of the low cost of steel wires [ 7 ]. Presently, there is a paucity of evidence regarding the comparative outcomes of two commonly used brands of monofilament stainless steel sutures for sternum closure.…”

Comparison of the short and medium term efficacy of ortholox UHMWPE sternal cerclage band system and figure-of-8 wire sternum closure technique in patients at risk for sternal dehiscence

“…It is also conveniently accessible and regarded as quite safe (1). Over forty methods have been created, including torque-adjustable tensioners, several types of metal and polymer bands, hook-screw plates, and hand tools that ensure wire tension (2). Cardiothoracic surgeons have been accessing the heart using median sternotomy since 1957.…”