Sternal Closure with Resorbable Synthetic Suture Material in Children

Abstract

The use of resorbable sutures for sternal closure after median sternotomy in children has developed to a clinically routine procedure. Since there is no follow-up study so far about the influence of these synthetic sutures on sternal stability, wound healing, and compatibility in children, we evaluated the use of polydioxanon (PDS) cord in children particularly regarding those properties. In 59 children (weighing up to 30 kg) we could show that the use of synthetic resorbable materials (Vicryl 4/0, PDS) allows a complication-free stability of the sternum, good wound healing, and very good compatibility. It is concluded that the use of PDS cord is a suitable and reliable method for sternal closure with good clinical results.

Mechanical comparison of median sternotomy closure in dogs using polydioxanone and wire sutures

“…The incidence of foreign body‐induced wound infection (Losanoff and others 2002) and aseptic instability (Luciani and others 2006) has prompted surgeons to use absorbable sutures in median sternotomies where the need for rigid and stable closure is well known, advocating that stability might not be the only decision maker in closure method selection. The use of polydioxanone in the primary closure of sternotomy has been largely reported in human beings (van Sterkenburg and others 1990, Kreitmann and others 1992, Schwab and others 1994, Keceligil and others 2000, Losanoff and others 2002, Luciani and others 2006). Initially, the use of polydioxanone was recommended for sternotomy closure in paediatric open cardiac surgery (Keceligil and others 2000) to prevent sutures from remaining permanently in immature patients.…”

Evaluation of Sternal Closure with Absorbable Polydioxanone Sutures in Children

“…12-14 Furthermore, absorbable sutures are easier to handle and reduce the risk of suture lines bleeding and postoperative pain. 13,15,16 More importantly, this point is noticeable that PDS suture is an efficacious approach in patients with postoperative cardiac arrest that emergency re-sternotomy for internal Cardiopulmonary Resuscitation (CPR) is needed. Although there are different approaches to sternal closure, Figure-of-8 suturing is believed to be more secure and less likely to cut the sternum, because of redistribution of shearing forces compared to simple interrupted closure.…”

Aortic Valve Replacement in a Patient with Severe Nickel Allergy

“…Sternal closure in this patient required a nickel‐free sternal wire able to meet the strength and biocompatibility characteristics needed for adequate osteosynthesis. Although many sutures are used in orthopedic surgery to reattach tendons, ligaments, and bones, 7 only a few case reports describe the use of alternative sutures in place of monofilament stainless steel in cardiac surgery 8–10 . Ahrtex FiberWire #2 polyblend suture was found to have superior characteristics in static and fatigue standard testing and in tensile and knot breach strength test than standard polyester suture, according to the methods outlined in USP 24 (United States Pharmacopoeia 24) 11 .…”