Rigid Plate Fixation for Closure of Emergent Sternotomies for Trauma

Area of Science:

• Trauma Surgery
• Surgical Innovation
• Thoracic Reconstruction

Background:

• Emergent sternotomy is critical in trauma care.
• Sternal closure methods include wire cerclage (WC) and rigid plate fixation (RPF).
• No prior studies compared RPF and WC for emergent sternotomy in trauma.

Purpose of the Study:

• To compare complication rates of rigid plate fixation versus wire cerclage for emergent sternotomy in trauma patients.
• To evaluate the feasibility of rigid plate fixation in this setting.

Main Methods:

• Retrospective cohort study of trauma patients undergoing emergent sternotomy (2018-2021).
• Comparison of outcomes between patients with sternal closure using wire cerclage (WC) and rigid plate fixation (RPF).

Main Results:

• Eleven patients in each group (WC vs. RPF).
• No significant differences in demographics, ISS, or admission characteristics.
• Similar rates of wound complications (WC: 27%, RPF: 9%, P=.58).
• No significant differences in hospital stay, ICU stay, or ventilator days.
• All patients survived to discharge.

Conclusions:

• Rigid plate fixation is a feasible option for sternal closure in emergent trauma sternotomies.
• No difference in wound-related complications was observed between RPF and WC.
• This study provides a foundation for future prospective research on trauma sternotomy closure techniques.