The Thoracic and cardiovascular surgeon
-
Thorac Cardiovasc Surg · Jun 2017
Comparative StudyTitanium Plate Fixation versus Conventional Closure for Sternal Dehiscence after Cardiac Surgery.
Background Postoperative sternal dehiscence with or without mediastinitis is a complication of cardiac surgery leading to considerable disability. Titanium plate fixation can provide sternal stability in patients with a dehiscent sternum. The aim of this study is to compare clinical outcomes of titanium plate fixation with conventional treatment methods such as steel wire cerclage and pectoralis muscle reconstruction. ⋯ Hospital stay was similar in both groups (10 [5-23] vs. 12 (5-21) days, p = 0.527). There was no inhospital mortality. Conclusion Titanium plate fixation is superior in stabilizing the sternal bone when compared with conventional refixation methods, especially in secondary closure after poststernotomy mediastinitis.
-
Thorac Cardiovasc Surg · Jun 2017
Randomized Controlled Trial Comparative StudyDouble-Wire versus Single-Wire Sternal Closure in Obese Patients: a Randomized Prospective Study.
Background Sternal instability after coronary artery bypass grafting (CABG) is a serious complication. Obese patients are at high risk for sternal instability after CABG. This study was conducted to assess the positive impact of double-wire sternal closure on sternal instability. ⋯ Logistic regression analysis showed sternal closure via double wires as an independent protection factor (odds ratio [OR]: 0.276; p = 0.029). Smoking (OR: 5.5; p = 0.006) and postoperative delirium (OR: 3.5; p = 0.033) turned out to be independent risk factors for the development of sternal instability. Conclusion Double-wire sternal closure significantly reduces postoperative sternal instability in obese patients undergoing isolated CABG with LIMA graft.