Rigid Plate Fixation Versus Wire Cerclage for Sternotomy After Cardiac Surgery: A Meta-Analysis

Tam, Derrick Y.; Nedadur, Rashmi; Yu, Monica; Yanagawa, Bobby; Fremes, Stephen E.; Friedrich, Jan O.

doi:10.1016/j.athoracsur.2018.02.043

Cited by 39 publications

(19 citation statements)

References 20 publications

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“…Additionally, wire loosening, especially in obese patients, results in the failure to provide adequate stabilization for optimal sternal healing. Several authors have investigated various sternal closure materials and technologies for sternal fixation [Tam 2018;Nenna 2019]. Nonetheless, the optimal technique for primary sternal closure remains unknown.…”

Section: Introductionmentioning

confidence: 99%

The Simple Technique of Sternal Closure Using An Absorbable Mesh Plate

Watanuki

Futamura

Tochii

et al. 2022

HSF

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Background: Several authors have investigated various sternal closure materials and technologies for sternal fixation; nonetheless, the optimal technique for primary sternal closure remains unclear. This study aimed to evaluate the sternal stability of a simple technique using a mesh-type plate (Super Fixorb MX40®; Takiron Co. Ltd., Osaka, Japan), as compared with wire cerclage. Methods: A total of 70 patients who underwent cardiovascular surgery through median sternotomy between July 2019 and May 2020 were included. Two pieces of mesh-type plates were placed under the sternum in combination with wiring. The technique for sternal closure was randomly applied, which was mainly based on the surgeon’s preferences: mesh plate (mesh group: N = 33) or conventional wire cerclage (wire group: N = 37). Sternal displacement was measured using computed tomography at discharge. Results: Pain scale scores and analgesic use on postoperative day 7 were similar between the two groups. However, the displacement in both the anterior-posterior and lateral directions was significantly smaller in the mesh group. Conclusions: The use of the mesh plate device for sternal closure is simple, safe, easy, and potentially reliable without anterior-posterior sternal displacement.

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Section: Introductionmentioning

confidence: 99%

The Simple Technique of Sternal Closure Using An Absorbable Mesh Plate

Watanuki

Futamura

Tochii

et al. 2022

HSF

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“…4 Bioengineering studies in various synthetic and cadaveric models have shown that rigid sternal fixation with plates, based on orthopedic principles, provides better results than wire cerclage. A recent RCT 5 and a recent meta-analysis 6 have validated these findings in the clinical setting. These findings raise the question of whether there is any value in comparing sternal plates with ZIP-FIX ties in the face of better results with rigid plate fixation.…”

Section: Polymer Cable Tie Closure Of the Sternum: Is It An Acceptablmentioning

confidence: 80%

Polymer cable tie closure of the sternum: Is it an acceptable fix?

Omer

2018

The Journal of Thoracic and Cardiovascular Surgery

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“…34,59,61 The benefits may especially be significant in patients at high risk of sternal dehiscence. 62 A recent, prospective, single-blinded, multicenter, randomized trial compared outcomes in patients undergoing median sternotomy for cardiac surgery at 12 US sites, Enhanced Recovery After Cardiac Surgery and closed either with rigid plates (n 5 116) or wire cerclage (n 5 120). 34 Importantly, the study excluded high-risk patients in order to understand the potential benefits of RPF for the general cardiac surgery population.…”

Section: Rigid-plate Fixationmentioning

confidence: 99%

Orthopedic Principles to Facilitate Enhanced Recovery After Cardiac Surgery

Gerdisch

Allen

Naka

et al. 2020

Critical Care Clinics

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Early patient mobilization is a major driver of recovery after cardiac surgery with open sternotomy. Instability of the healing sternal osteotomy hinders postoperative patient movement, causes pain, and puts patients at risk of complications, necessitating restrictive sternal precaution protocols. Sternal closure with wire cerclage does not adequately satisfy the three fundamental principles of orthopedic healing: approximation, compression, and rigid fixation. Selection of sternal closure methods according to orthopedic principles promotes accelerated recovery and return to normal activities while reducing pain and requirements for opioid analgesics.

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Rigid Plate Fixation Versus Wire Cerclage for Sternotomy After Cardiac Surgery: A Meta-Analysis

Cited by 39 publications

References 20 publications

The Simple Technique of Sternal Closure Using An Absorbable Mesh Plate

The Simple Technique of Sternal Closure Using An Absorbable Mesh Plate

Polymer cable tie closure of the sternum: Is it an acceptable fix?

Orthopedic Principles to Facilitate Enhanced Recovery After Cardiac Surgery

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