• Amber Malhotra, Pankaj Garg, Arvind Kumar Bishnoi, Varun Pendro, Pranav Sharma, Madhav Upadhyay, and Sanjay Gandhi.
• Department of Cardiothoracic and Vascular Surgery, U. N. Mehta Institute of Cardiology and Research Center, Ahmedabad, Gujarat, India.
• Asian Cardiovasc Thorac Ann. 2014 May 1; 22 (4): 409-15.

IntroductionMedian sternotomy is the preferred approach for open heart surgeries. The sternotomy incision is predominantly closed with either steel wire or polyester suture. The type of material used is primarily based on the surgeon's choice, and both materials achieve a good result. No prospective clinical study has been undertaken to evaluate differences in the incidence of wound infection and the degree of pain associated with both techniques.Patients And MethodsOur randomized controlled double-blind study included 200 adults undergoing single-valve replacement. The technique of surgery, apart from the material used for sternal closure, was the same in both groups. Postoperatively, patients were analyzed for wound infection and wound pain based on the ASEPSIS score and Numeric Pain Rating Score, respectively.ResultsThe polyester suture group had a significantly higher mean ASEPSIS score, indicating a higher incidence of wound infection, and more late wound complications. The polyester suture group also had a significantly higher mean pain score. The steel wire group had significantly higher mediastinal drain output in the first 48 h after surgery.ConclusionThe use of polyester suture for sternal closure in adult patients results in increased wound infection, wound pain, and late wound complications, but lower mediastinal drain output.

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