Intramedullary reinforcement of sternal fixation with autologous xiphoid tenon

Chang, Jen‐Ping

doi:10.21037/jtd.2017.12.63

Cited by 2 publications

(2 citation statements)

References 8 publications

(11 reference statements)

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“…In comparison to a traditional median sternotomy, a xiphoid-sparing median sternotomy is effective in reducing the risk of wound and mediastinal infections [20]. Intramedullary incarceration of a cancellous portion of the autologous xiphoid can also promote healing of the sternum and reduce the probability of pseudo-joint formation [21].…”

Section: Discussionmentioning

confidence: 99%

Analysis of sternal healing after median sternotomy in low risk patients at midterm follow-up: retrospective cohort study from two centres

Wang

Min

et al. 2019

J Cardiothorac Surg

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BackgroundFor low risk patients undergoing median sternotomies, no midterm follow-up studies involving sternal healing have been conducted. In this study we evaluated sternal healing in low risk patients by chest CT scan and the risk factors associated with poor healing were analyzed.MethodsPatients who underwent sternal median incision heart surgery from September 2014 to March 2015 were recruited. The clinical information of these patients during hospitalization was collected, and the CT scan data were submitted to the two chief physicians of the Radiology Department for radiographical sternal healing score determination. Based on the method of wound closure, the patients were divided into sternum plate (Plates) and wire groups (Wires).ResultsForty-four patients were recruited. The mean CT examination time was 17.27 ± 2.30 months postoperatively. Twenty-nine (65.9%) patients met the criteria for radiographic sternal healing. Three segments, including the aortopulmonary window, the main pulmonary artery, and the aortic root, had healed less in comparison to the manubrium segment. Compared to patients in whom 6–7 metal wires were used for sternal closure, healing of the lower sternum was worse in patients in whom five wires were used, but the difference in healing was not statistically significant. Univariate analysis of sternal healing showed that patient age was a risk factor for sternal non-healing. When the patient age was > 45 years, the predicted risk of radiographic sternal non-union was 1.833 (95% CI: 1.343–2.503).ConclusionsAt the mid-term follow-up, 65.9% of patients undergoing median sternotomies demonstrated radiographic sternal healing. Age, but not closure device, was a risk factor for sternal non-healing in low risk patients. Use of more wires had a positive impact on sternal healing.Trial registrationresearchregistry4918, registered 28 May 2019, retrospectively registered.

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Section: Discussionmentioning

confidence: 99%

Analysis of sternal healing after median sternotomy in low risk patients at midterm follow-up: retrospective cohort study from two centres

Wang

Min

et al. 2019

J Cardiothorac Surg

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“…These results are not in line with the results of studies that prove that an approximation with stainless steel wire is as effective as an approximation with PDS in preventing sternal dehiscence. [17][18][19][20][21]…”

Section: Discussionmentioning

confidence: 99%

Comparison of Sternum Approximation Stability Using Stainless Steel Wire with Polydioxanone (PDS)

Kartono¹,

Satria²,

Bahar³

2022

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Background: The median sternal incision is an incision that is commonly done in heart surgery and vascular surgery. The existing techniques need elaboration and innovation to produce a method with an optimal level of healing effectiveness accompanied by a minimal risk of side effects. This study aims to determine the difference between sternal approximation using stainless steel wire compared to polydioxanone (PDS) based on biomechanical analysis. Methods: This was an in vitro experimental study using the sternum of a goat. A total of 24 sternums were divided into 6 treatment groups. Data analysis was performed with SPSS version 20. Univariate and bivariate analyzes were performed to compare the sternal approximation between stainless steel wire and PDS. Results: The use of PDS showed a higher average increase in transverse and longitudinal approximations compared to the use of stainless steel wire and was statistically different, p<0.05. PDS does not differ from stainless steel wire in lateral approximation. Conclusion: Stainless steel wire is more optimal in maintaining sternal stability than PDS based on biomechanical tests.

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Intramedullary reinforcement of sternal fixation with autologous xiphoid tenon

Cited by 2 publications

References 8 publications

Analysis of sternal healing after median sternotomy in low risk patients at midterm follow-up: retrospective cohort study from two centres

Analysis of sternal healing after median sternotomy in low risk patients at midterm follow-up: retrospective cohort study from two centres

Comparison of Sternum Approximation Stability Using Stainless Steel Wire with Polydioxanone (PDS)

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