The outcome of sternal wire removal on persistent anterior chest wall pain after median sternotomy

Abstract

The surgical results were generally good. Sternal wire removal should be offered to patients with persistent anterior chest wall pain after sternotomy, when other serious postoperative complications have been excluded.

Chronic Poststernotomy Pain

“…Their removal after healing has been associated with a significant improvement in reported chest pain; however, other causes of persistent chest pain must be excluded. [133][134][135][136][137][138][139] Psychological Interventions…”

Does removal of steel wires relieve post-sternotomy pain after cardiac surgery?

“…These findings are comparable to a previous study of Nørgaard and colleagues. 3 Their study included 95 patients; 86% reported complete or partial relief of pain after removal of their steel wires. Assuming that the indication for steel wire removal in the groups with worse or similar pain levels was not strong, we looked carefully at the patients' data to find any clue for other causes of pain.…”

“…These findings are comparable to a previous study of Nørgaard and colleagues. 3 Their study included 95 patients; 86% reported complete or partial relief of pain after removal of their steel wires.…”

“…2 Removal of sternal wires for pain relief has been reported in 0.6%–1.1% of sternotomies. 3 Persistent anterior chest pain that continues or arises weeks or months after a median sternotomy, in the absence of cardiac ischemia and sternal instability, is most commonly due to the sternal wire sutures or a protruding wire. Other causes such as scar-entrapped sensory nerve fibers and a hypersensitivity to the nickel in stainless steel have also been described.…”

Minimize the risk of chronic pain after cardiac surgery by treating acute postoperative pain

“…In patients presenting with postsurgical chest pain, other potential causes of pain such as mediastinitis, myocardial ischaemia and sternal instability should be excluded [1]. Treatment may be surgical or nonsurgical, and some patients with post-sternotomy pain may benefit from the removal of sternal wires [25,26]. [3] Proposed updated definition (Werner and Kongsgaard) [4] The pain developed following surgery…”