A rapid, secure method of sternal closure

In 1977 Robicsek(1) described a method of sternal closure that involved a double wire on each side of the sternum, with appropriate circumferential wires. Shortly thereafter, we modified that procedure, as shown in Figure 1. Only one wire is used on each side of the sternum, and fewer circumferential wires are needed. This type of sternal closure can be performed as rapidly as the usual closure of simple circumferential wire sutures and is much more secure, because the circumferential wires cannot cut through the parasternal wire. After using this method in about 100 patients with either poor sternal bone or chronic lung disease, we have encountered no subsequent sternal separation.