Sternal Pin Used to Close Sternum in Infants after Cardiac Surgery
Wen-Peng Xie1, Xiu-Hua Chen1, Si-Jia Zhou1
1Department of Cardiac Surgery, Fujian Children's Hospital (Fujian Branch of Shanghai Children's Medical Center), College of Clinical Medicine for Obstetrics and Gynecology and Pediatrics, Fujian Medical University, Fuzhou, China.
Insights
Bioabsorbable sternal pins combined with steel wire improve sternal stability in infants after cardiac surgery. This method reduces thoracic deformity and sternal displacement, enhancing outcomes for pediatric patients.
Area of Science:
- Pediatric Cardiac Surgery
- Thoracic Reconstruction
- Biomaterials in Medicine
Background:
- Sternal closure is critical after infant cardiac surgery.
- Traditional methods like steel wire can lead to thoracic deformities.
- Novel techniques are needed to improve sternal stability and aesthetic outcomes.
Purpose of the Study:
- To evaluate the efficacy of bioabsorbable poly-L-lactic acid sternal pins for sternal closure in infants undergoing cardiac surgery.
- To compare the incidence of thoracic deformity and sternal instability between different closure methods.
Main Methods:
- A retrospective study of 170 infants undergoing cardiac surgery.
- Patients were divided into three groups: steel wire, PDS cord, and steel wire + sternal pin.
- Thoracic deformity assessed using vertebral index (VI), frontosagittal index (FSI), and Haller index (HI); sternal stability evaluated by dehiscence and displacement.
Main Results:
- The steel wire + sternal pin group showed significantly lower differences in VI and HI compared to the PDS cord group.
- This combined group exhibited reduced deformation rates and lower incidence of sternal displacement compared to steel wire and PDS cord groups.
- No sternal dehiscence or complete sternal healing observed in any group at 1-year follow-up.
Conclusions:
- Combining steel wire with bioabsorbable sternal pins enhances sternal closure in infants post-cardiac surgery.
- This approach effectively reduces sternal deformity and displacement, improving overall sternal stability.
- Bioabsorbable sternal pins offer a promising alternative for optimizing surgical outcomes in pediatric cardiac patients.
Objective:
A retrospective study was conducted to explore the efficacy of bioabsorbable poly-L-lactic acid sternal pins in sternal closure in infants after cardiac surgery.
Methods:
A total of 170 infantile patients who underwent cardiac surgery were divided into the steel wire group (group A), the PDS cord group (group B), and the steel wire + sternal pin group (group C). The occurrence of the thoracic deformity was evaluated by vertebral index (VI), frontosagittal index (FSI), and Haller index (HI) values; the stability of the sternum was evaluated by detecting sternal dehiscence and displacement.
Results:
By comparing the absolute values of the differences in VI, FSI, and HI in the three groups, it was found that the difference values of VI and HI in group C were significantly lower than those in group B (p = 0.028 and 0.005). For the highest deformation index, the deformation rate of infants in group C before discharge and during the 1-year follow-up was lower than that in group A and group B (p = 0.009 and 0.002, respectively). The incidence of sternal displacement in group C was also significantly lower than that in groups A and B (p = 0.009 and 0.009). During the 1-year follow-up, there was no sternal dehiscence, and the sternum healed completely in the three groups.
Conclusion:
The use of "steel wire + sternal pin" for sternal closure in infants after cardiac surgery can reduce the occurrence of sternal deformity, reduce anterior and posterior displacement of the sternum, and improve sternal stability.
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