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Potential risk of sternal wires
Chun-Che Shih1, Chun-Ming Shih, Yea-Yang Su
1Institute of Clinical Medicine, National Yang-Ming University School of Medicine, Taipei 112, Taiwan, ROC. ccshih@vghtpe.gov.tw
Summary
Fracture of stainless steel sternal wires, used after open-heart surgery, is linked to stress and poor wire quality. Analysis revealed cracks, corrosion, and aluminum oxide inclusions on fractured wire surfaces.
Area of Science:
- Biomaterials Science
- Cardiothoracic Surgery
- Materials Engineering
Background:
- Sternal wires are crucial for sternal closure after open-heart surgery.
- Sternal dehiscence can lead to complications, including wire failure.
- Understanding sternal wire failure mechanisms is vital for improving patient outcomes.
Purpose of the Study:
- To investigate the fracture mechanism of stainless steel sternal wires.
- To analyze surface alterations and fractured ends of explanted sternal wires.
- To identify factors contributing to sternal wire failure.
Main Methods:
- Collection of fractured and non-fractured sternal wires from patients with sternal dehiscence.
- Cleaning of wires and removal of fibrotic tissues.
- Analysis using scanning electron microscopy and energy dispersive X-ray analysis (EDXA).
Main Results:
- Fractured wires exhibited severe transversal cracks and crevice corrosion.
- Energy dispersive X-ray analysis (EDAX) detected aluminum oxide inclusions on fractured surfaces.
- Findings suggest material defects and environmental factors contribute to failure.
Conclusions:
- The combined effect of mechanical stress and suboptimal wire quality likely causes sternal wire failure.
- Corrosion and material inclusions are significant factors in sternal wire fracture.
- This study highlights the need for improved quality control in sternal wire manufacturing.