Nylon-Band Chest Closure

LeVeen, Harry L.; Piccone, Vincent A.

doi:10.1001/archsurg.1968.01330190038009

Cited by 34 publications

(10 citation statements)

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“…The first bands used to close the sternum were made of nylon (DuPont Chemical Corp., Wilmington, DE) [24], and were associated with a high number of complications such as infection, dehiscence, draining sinuses and chronic pain [25]. Bands of Mercilene (Ethicon Inc., Sommerville, NJ) or metal [26] fared better, but because of their clumsy handling and higher cost, they did not become popular.…”

Section: Sternal Closurementioning

confidence: 99%

Sternal Instability After Midline Sternotomy

Robicsek¹,

Fokin²,

Cook³

et al. 2000

Thorac cardiovasc Surg

154

152

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Section: Sternal Closurementioning

confidence: 99%

Sternal Instability After Midline Sternotomy

Robicsek¹,

Fokin²,

Cook³

et al. 2000

Thorac cardiovasc Surg

154

152

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“…Polyethylene terephthalate ribbon, jacketed steel wires, and steel bands have been tried but have not been widely adopted, possibly because of the complexity of application [ 16 , 19 , 28 , 29 ]. Nylon bands are associated with an increased incidence of DSWI [ 30 , 31 ].…”

Section: Discussionmentioning

confidence: 99%

Reduction in deep sternal wound infection with use of a peristernal cable-tie closure system: a retrospective case series

Stelly

Rodning

Stelly

2015

J Cardiothorac Surg

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BackgroundDeep sternal wound infections are a rare but serious complication after median sternotomy. We evaluated the incidence of deep sternal wound infection associated with two techniques for sternal closure.MethodsIn this retrospective case series, we recorded the method of sternal closure in consecutive patients undergoing a variety of cardiothoracic surgical procedures. Sternal closure in the historical control group was performed using trans-sternal, stainless-steel wire sutures; subsequent patients were closed using wire sutures in conjunction with a novel, peristernal cable-tie closure system to reinforce the corpus sterni. Perioperative care was standardized between groups. Demographics, risk factors, and postoperative outcomes were analyzed.ResultsBetween July 2010 and July 2014, 609 consecutive adult patients underwent sternal closure following open median sternotomy at a single hospital in Mobile, Alabama. Sternal closure was accomplished with wire sutures in the first 309 patients and with cable-tie reinforcement in the subsequent 300 patients. Baseline characteristics were comparable between groups, except that the cable-tie group exhibited greater preoperative comorbidity. Mean body mass index was comparable between groups (30.2 ± 6.6 kg/m2 wire suture versus 30.5 ± 7.7 cable-tie, p = 0.568). Deep sternal wound infection occurred in 2.6 % (8/309) patients in the wire-suture group, whereas no deep sternal wound infections were observed in the cable tie group (p = 0.008).ConclusionsThe peristernal cable-tie system was a simple and reliable method for sternal closure after open median sternotomy, and was associated with a reduced risk of deep sternal wound infection, even in an obese and comorbid population.

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“…41 LeVeen and Piccone described the use of nylon tapes for closure in an attempt to reduce sheering forces associated with wiring. 42 Although the use of nylon tapes was discontinued due to high complication rates, they have been replaced by Mersilene tapes (Ethicon, Cincinnati, OH). Mersilene tapes act to reduce shearing and rates or nonunion, and complication rates are similar to alternative methods of fixation.…”

mentioning

confidence: 99%

Late Complications of Chest Wall Reconstruction: Management of Painful Sternal Nonunion

Chepla¹,

Salgado²,

Tang³

et al. 2011

Seminars in Plastic Surgery

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Although rare, sternal nonunion after median sternotomy or traumatic injury is associated with a high rate of morbidity. Pain and sternal clicking are two of the most common complaints and reasons these patients seek evaluation and treatment. Diagnosis of sternal nonunion is based on a thorough history and physical examination and can be confirmed with subsequent radiographic imaging. The treatment for symptomatic sternal nonunion requires stable fixation of the bony fragments and chest wall after the debridement of all nonviable bony and soft tissue by the cardiothoracic or reconstructive surgery team. Multiple fixation techniques have been described and incorporate a wide variety of materials including combinations of wires, cables, pins, bands, staples, and plates. Most recently, several new commercially available plating systems have demonstrated low recurrence and complication rates and resolution of the patient's symptoms on follow-up evaluation. Included in this review are three cases demonstrating the management of symptomatic sternal nonunion using these new techniques and review the history, diagnosis, risk factor, and classification, as well as several of the previously described fixation methods.

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Nylon-Band Chest Closure

Cited by 34 publications

References 0 publications

Sternal Instability After Midline Sternotomy

Sternal Instability After Midline Sternotomy

Reduction in deep sternal wound infection with use of a peristernal cable-tie closure system: a retrospective case series

Late Complications of Chest Wall Reconstruction: Management of Painful Sternal Nonunion

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