Comparison of figure-of-eight and simple wire sternal closure techniques in patients with non-microbial sternal dehiscence


Tekümit H., Cenal A. R., Tataroǧlu C., Uzun K., Akinci E.

Anadolu Kardiyoloji Dergisi, cilt.9, sa.5, ss.411-416, 2009 (SCI-Expanded) identifier identifier identifier identifier

  • Yayın Türü: Makale / Tam Makale
  • Cilt numarası: 9 Sayı: 5
  • Basım Tarihi: 2009
  • Dergi Adı: Anadolu Kardiyoloji Dergisi
  • Derginin Tarandığı İndeksler: Science Citation Index Expanded (SCI-EXPANDED), Scopus, TR DİZİN (ULAKBİM)
  • Sayfa Sayıları: ss.411-416
  • Anahtar Kelimeler: Sternal dehiscence, coronary artery bypass surgery, sternal closure, figure-of-eight, simple wire technique, non-microbial dehiscence
  • İstanbul Gelişim Üniversitesi Adresli: Hayır

Özet

Objective: Sternal dehiscence is a serious and potentially devastating complication. The present study compared the effects of two sternal closure techniques, simple wire technique and figure-of-eight technique, on the development and outcome of non-microbial sternal dehiscence. Methods: Medical records of all adult patients (n=6211) that underwent cardiac operations in our clinic through median sternotomy between January 2002 and August 2008 were retrospectively reviewed for the development of non-microbial sternal dehiscence. The outcomes of 90 (1.44%) isolated on-pump coronary artery bypass surgery (CABG) cases that developed dehiscence were analyzed with Student's t test, Mann Whitney U test, Chi-square test and Fisher's Exact test according to the type of sternal closure: figure-of-eight or simple wire technique. Survival analysis was made with Kaplan Meier test. Results: Figure-of-eight and simple wire technique were associated with similar rates of sternal dehiscence (1.46% and 1.43%, respectively). In addition, after the development of sternal dehiscence, these techniques were associated with similar mortality rates and postoperative outcomes (time to sternal re-fixation, prolonged ICU stay, intraaortic balloon counterpulsation use and chest re-exploration inotropic agent use and postoperative cerebrovascular accident). One patient died in each group (2.6% vs. 1.9%, respectively). Conclusion: In conclusion, present findings suggest that the most commonly used sternal closure techniques, figure-of-eight technique and simple wire technique, may have similar outcomes in terms of development and prognosis of non-microbial dehiscence in patient undergoing isolated on-pump CABG operations. ©Copyright 2009 by AVES Yayincilik Ltd.