Evaluation of sternal closure with absorbable polydioxanone sutures in children
Hamid Bigdelian1, Mohsen Sedighi2
1Department of Cardiac Surgery, Isfahan University of Medical Sciences, Isfahan, Iran.
Insights
Polydioxanone sutures effectively prevent sternal wound complications in pediatric open heart surgery. This absorbable suture, used with a figure-of-eight technique, proved safe and successful in preventing mediastinitis and sternal dehiscence.
Area of Science:
- Pediatric Cardiac Surgery
- Surgical Materials Science
Background:
- Median sternotomy can lead to serious complications like sternal dehiscence, wound infection, and mediastinitis.
- These complications significantly increase patient morbidity and mortality.
- Absorbable polydioxanone sutures show promise in preventing these adverse events in pediatric patients.
Purpose of the Study:
- To evaluate the efficacy of polydioxanone sutures in preventing sternal wound complications after median sternotomy in children.
- To assess the safety and clinical outcomes of using polydioxanone sutures with a figure-of-eight technique for sternal closure.
Main Methods:
- A study involving 620 pediatric patients (newborn to 15 years) undergoing median sternotomy over two years.
- Utilized absorbable polydioxanone sutures with a figure-of-eight technique for sternal closure.
- Standardized surgical protocols were followed for all interventions.
Main Results:
- No instances of broken sternal sutures were reported.
- Zero cases of mediastinitis were observed.
- A very low rate of sternal dehiscence (0.32%) was recorded, with follow-up ranging from 1 to 132 months.
Conclusions:
- Sternal closure using polydioxanone sutures combined with the figure-of-eight technique is a safe and effective method for pediatric patients.
- This approach yields favorable clinical results, significantly reducing sternal wound complications.
- The study supports the use of polydioxanone sutures as a reliable option in pediatric cardiac surgery.
Introduction:
Sternal dehiscence, sternal wound infection and mediastinitis are troublesome complications following median sternotomy which are major causes of morbidity and mortality of patients. Synthetic polydioxanone absorbable suture seems effective in prevention of these complications in children undergoing open heart surgery.
Methods:
During 2 years period, 620 patients who underwent median sternotomy were studied. The efficacy of absorbable polydioxanone suture was tested on patients using figure-of-eight suture technique. The patients' age ranged from newborn to 15 years old. All surgical interventions were performed according to a standard protocol.
Results:
No sternal sutures were broken during the sternal closure and no case of mediastinitis was seen. Two patients experienced sternal dehiscence (0.32%). Follow-up period of patients were established between 1 to 132 months after open heart surgery.
Conclusion:
Sternal closure with the polydioxanone suture in combination with figure-of-eight technique is a safe and suitable method in children with good clinical results.
