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

Abstract

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.

Comparison of Karydakis flap reconstruction versus primary midline closure in sacrococcygeal pilonidal disease: Results of 200 military service members

“…Besides not establishing cavity drainage where needed, the approximation of wound edges with tension may facilitate dehiscence and infective complications, which may occur with primary closure at the midline despite aseptic technique. 27 Pilonidal surgery differs from other kinds of wounds or incisions for which primary closure may be used as a reasonable closure method. 28,29 Following pilonidal surgery, many patients can feel themselves ready to return to normal activity in a short time.…”

Vacuum-assisted closure and bilateral pectoralis muscle flaps for different stages of mediastinitis after cardiac surgery

“…1 Overall, 0.15%-5% of patients who undergo cardiac surgery will experience deep sternal wound infection (DSWI), resulting in mortality rates of between 14% and 47%. 2 The incidence of DSWI after coronary artery bypass grafting (CABG) was 0.63% in a recent review of the Society of Thoracic Surgeons adult cardiac surgery database, and was strongly associated with major morbidity and mortality.…”

Biomechanical Comparison of Wire Circlage and Rigid Plate Fixation for Median Sternotomy Closure in Human Cadaver Specimens

“…Insufficient postoperative sternal rigidity or sternal instability in the early postoperative period has been associated with a two to four times greater incidence of wound complications, mediastinitis, and chronic sternal infections [5]. Separate reports have also claimed that this insufficient stability is one of the most important factors 7 influencing the development of mediastinitis [6]. It is statistically shown that in cases where mediastinitis supervenes, 47% of patients die [2].…”

“…One claim asserts that figure-eight pericostal closure (Figure 3.7) has the highest failure rate compared to other popular steel wire methods [10], while others claim that figure-eight suturing is safer than simple wires [6] and have the least permanent displacement under load [15]. Clinical observation suggests that figure-of-eight, results in uneven tension.…”

“…Complete immobilization of the area is critical to prevent severed blood vessels or damaging the woven bone. Sufficient immobilization may lead to faster healing times when compared to the insufficient immobilization achieved by wire closure methods [6].…”