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Related Experiment Videos

Fatigue testing median sternotomy closures.

A R Casha1, M Gauci, L Yang

  • 1Department of Cardio-thoracic Surgery, Leeds General Infirmary, LS1 3EX, Leeds, UK.

European Journal of Cardio-Thoracic Surgery : Official Journal of the European Association for Cardio-Thoracic Surgery
|March 17, 2001
PubMed
Summary
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Peristernal and sternal band sternotomy closure techniques significantly reduce bone cutting compared to standard wire closure. Polyester and figure-of-eight methods require caution due to higher rates of bone cutting.

Area of Science:

  • Biomedical Engineering
  • Surgical Innovation
  • Materials Science in Medicine

Background:

  • Sternal dehiscence, a serious complication, often results from sternal wire cutting through bone.
  • Evaluating sternotomy closure techniques is crucial for improving patient outcomes and reducing surgical complications.

Purpose of the Study:

  • To quantitatively assess and compare the rate of bone cutting for five distinct median sternotomy closure techniques.
  • To identify superior closure methods that minimize sternal wire migration through bone.

Main Methods:

  • A biological sheep sternum model was utilized to test standard steel wire, peristernal steel wire, figure-of-eight, polyester, and sternal band closure techniques.
  • Fatigue testing was conducted using a computerized materials-testing machine, applying loads from 1 to 10 kg to measure displacement and calculate percentage cut-through.

Related Experiment Videos

  • Paired adjacent bone samples were used to control for biological variability, with each closure method tested against standard closure.

    • Main Results:

    • Peristernal (0.72 mm) and sternal band (0.66 mm) closures showed significantly less displacement than standard closure (0.22 mm).
    • Polyester (1.01 mm) and figure-of-eight (0.52 mm) closures also exhibited significant differences in displacement compared to standard closure.
    • Statistically significant differences in the percentage of bone cut-through were observed across all tested closure methods versus standard closure (ANOVA, P<0.001).

    Conclusions:

    • Peristernal and sternal band sternotomy closure techniques demonstrate significantly superior performance in preventing bone cutting compared to standard wire closure.
    • The study quantifies the differing rates of bone cutting for various closure methods in a sheep sternum model.
    • Caution is advised when using polyester and figure-of-eight closure techniques due to their bone-cutting characteristics.