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Related Concept Videos

Tracheostomy: Procedure and Tubes01:28

Tracheostomy: Procedure and Tubes

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A tracheostomy is a surgical procedure that creates an artificial opening into the trachea, typically at the second or third cartilaginous ring level. This opening allows the insertion of a tracheostomy tube, which can replace an endotracheal tube, provide mechanical ventilation, bypass an upper airway obstruction, or remove accumulated tracheobronchial secretions.
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Tracheostomy Decannulation01:21

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Tracheostomy decannulation is a significant milestone in the liberation of mechanically ventilated patients. Despite its importance, there is no universally accepted protocol for this procedure. This demands an evidence-based, individualized approach.
Description of the Procedure
Decannulation refers to the permanent removal of the tracheostomy tube, signaling the resolution of the condition that initially necessitated the tracheostomy. The process requires a well-coordinated interplay between...
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Related Experiment Video

Updated: Jul 12, 2025

Surgical Fixation of Sternal Fractures: Preoperative Planning and a Safe Surgical Technique Using Locked Titanium Plates and Depth Limited Drilling
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FlatWire Sternal Closure System technique for median sternotomy closure.

Audrey L Khoury1, Sapna Patel2, Smith Ngeve2

  • 1Division of Cardiothoracic Surgery, Department of Surgery, University of North Carolina School of Medicine, Chapel Hill, NC, USA.

Journal of Thoracic Disease
|October 23, 2023
PubMed
Summary

The Figure 8 FlatWire Sternal Closure System offers a stronger alternative to traditional sternal wires, significantly reducing sternal cut-through and postoperative pain after median sternotomy.

Keywords:
Sternal closuresternal wiresternotomy

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Area of Science:

  • Cardiovascular Surgery
  • Biomedical Engineering
  • Surgical Innovation

Background:

  • Traditional median sternotomy closure uses stainless steel wire cerclage.
  • This method can lead to sternal instability, dehiscence, non-union, and increased pain.
  • Novel closure systems aim to improve outcomes and reduce complications.

Purpose of the Study:

  • To demonstrate the technique of the Figure 8 FlatWire Sternal Closure System.
  • To compare the efficacy and safety of FlatWire closure with traditional sternal wires.
  • To highlight the benefits of the FlatWire system in sternal approximation.

Main Methods:

  • The FlatWire system involves placing FlatWires around the sternum and securing them through a security box.
  • A Figure 8 tensioning device is used to achieve appropriate tensile force.
  • Wires are temporarily held by rotation and then twisted for permanent approximation.

Main Results:

  • The Figure 8 FlatWire Sternal Closure System is stronger than traditional wire cerclage.
  • FlatWire closure significantly reduces sternal cut-through and postoperative pain.
  • No significant differences were observed in hospital length of stay or cost.

Conclusions:

  • The Figure 8 FlatWire Sternal Closure System is a viable and effective alternative for sternal closure.
  • This technique offers improved biomechanical strength and reduced patient discomfort.
  • Mastering the FlatWire technique may involve an initial learning curve affecting operative time.