Closure of Longitudinal Sternotomy with Absorbable Sutures

Abstract

In a consecutive series of 150 patients who underwent open heart surgery, absorbable suture (PDS-Ethicon) were used for the closure of median sternotomy. One patient developed sternal dehiscence; wound complications or incompatibility with the suture material did not occur. With the technique of "double" PDS sutures, rapid and secure sternal closure can be performed even in cases of friability of the sternum without cutting through the sternal bone.

Are absorbable sutures inadequate to close the sternum?

“…Pigtail catheters using the modified Seldinger technique have been found to be well tolerated by the patient and are highly effective in drainage of pleural serous and chylous effusions but less efficacious in drainage of hemothorax or pneumothorax and empyema with acceptable risk of complications. 2 We agree that akin to small catheters using the Seldinger technique, 3,4 Bonnano's catheter can be used. However, with the length of the trocar and the mounted catheter being approximately 30 cm, one can lose track of the distance traveled in the thoracic cavity because there are no obvious markings on the catheter itself, and one can injure vital organs in the chest cavity, as in our institution's experience (unpublished report), in which a misplaced Bonnano's catheter pierced the left ventricle, and the tip of the catheter was found in the aortic root.…”

“…However, negative results have been reported only with polydioxanone, and this might indicate a different clinical performance of the 2 materials with respect to sternal closure. 1,4 One has to consider, however, that dehiscence of a median sternotomy after cardiothoracic surgery is about 1% in the literature. 2 Therefore the figure of 0.8% (3/ 350) in the report by Usui and colleagues 1 should not be thought of as unacceptable.…”