Delayed chest wall pain due to sternal wire sutures.

Area of Science:

• Cardiovascular Surgery
• Pain Medicine
• Biomaterials Science

Background:

• Median sternotomy is a common surgical approach.
• Sternal wire closure is standard practice.
• Chest wall pain can be a complication post-sternotomy.

Purpose of the Study:

• Investigate the cause of disabling chest wall pain after sternotomy.
• Identify the role of sternal wire sutures in post-operative pain.
• Evaluate the efficacy of surgical intervention for wire-related pain.

Main Methods:

• Retrospective analysis of 18 patients with chest wall pain post-median sternotomy.
• Histopathological examination of involved sternal wires and surrounding tissue.
• Electrophysiological measurements and Ferroxyl testing on selected wires.
• Surgical removal of problematic sternal wires and associated fibrous tissue.

Main Results:

• 18 patients experienced chest wall pain 2-84 months post-sternotomy.
• Pain was associated with exaggerated fibrous tissue reaction around twisted wires.
• Histology revealed sensory nerve fiber entrapment in fibrous tissue.
• Elevated electrical potentials and iron ion collection indicated wire corrosion and damage.
• Surgical removal of wires and tissue resolved pain and tenderness.

Conclusions:

• Damaged and corroded sternal wire sutures can cause significant chest wall pain.
• Nerve entrapment within fibrous tissue around sternal wires is a primary mechanism.
• Surgical intervention to remove problematic sternal wires offers effective pain relief.