Single wire versus double wire loops for median sternotomy closure: experimental biomechanical study using a human
Julian E Losanoff1, Marc D Basson, Scott A Gruber
1Department of Surgery, John D. Dingell VA Medical Center, Detroit, Michigan 48201, USA. jelosanoff@yahoo.comtel
The Annals of Thoracic Surgery
|September 25, 2007
Summary
Double wire closure for median sternotomy offers superior stability compared to single wire closure. This biomechanical study in a human cadaver model confirms enhanced strength and reduced displacement with double wires.
Area of Science:
- Biomechanical Engineering
- Surgical Innovation
- Anatomical Studies
Background:
- Reliable sternal fixation is crucial for median sternotomy healing.
- Existing single and double wire closure kits lack comparative experimental data.
- A novel human cadaveric model was utilized for stability assessment.
Purpose of the Study:
- To compare the biomechanical stability of single versus double wire sternal closures.
- To evaluate sternal union integrity under physiological load conditions.
- To provide evidence-based recommendations for sternotomy closure techniques.
Main Methods:
- Human cadaveric sternal plates (n=16) were secured with custom clamps.
- Biomechanical testing device applied repetitive, increasing force loads (0-800 N).
- Stability assessed by measuring permanent displacement in single and double wire closure groups.
Main Results:
- No significant differences in age or sex between groups.
- No device or specimen failures were reported during testing.
- Double wire closure demonstrated significantly less permanent displacement than single wire closure.
Conclusions:
- Double peristernal wire closure exhibits superior biomechanical stability.
- This finding suggests enhanced strength and fixation in double wire techniques.
- The human cadaver model provides valuable insights into in vivo sternotomy closure performance.