[MSB-44] Evaluation of Sternum Closure Methods with Clinical Results in Open Heart Surgery
Yusuf Kuşçu1, Dilşad Amanvermez Şenarslan1, Ahmet İhsan İşkesen1
1Department of Cardiovascular Surgery, Manisa Celal Bayar Univeristy, Faculty of Medicine, Manisa, Türkiye.
Objective:
This study aimed to investigate the clinical results of sternum closure methods after open heart surgery with median sternotomy.
Methods:
This retrospective study screened 2,662 patients who underwent open heart surgery. Classical steel wire, Flexigrip + steel wire combination, sternal cable, sternal band, and Robicsek were used as sternum closure methods in patients. The causality relationships of sternal dehiscence, diabetes mellitus, chronic obstructive pulmonary disease, impaired kidney function, and demographic characteristics of the patients were investigated.
Results:
Ninety-six patients developed dehiscence, and 60% of them had diabetes, 25% had impaired renal function, and 21% had chronic obstructive pulmonary disease. The treatment success rate was 88% when using the Flexigrip + steel wire combination in patients undergoing sternal dehiscence repair, and the treatment success rate was 76% using a standard steel wire. The combination of Flexigrip + steel wire significantly reduced the risk of sternal dehiscence compared to the use of classical steel wire in sternal closure. Vacuum-assisted closure devices were beneficial in draining wounds and shortened the healing time.
Conclusion:
Flexigrip + steel wire combination in sternal closure significantly reduced the risk of sternal dehiscence in patients with diabetes mellitus, chronic obstructive pulmonary disease, and impaired kidney function.
Insights
The Flexigrip + steel wire combination for sternum closure significantly reduces sternal dehiscence risk, especially in patients with diabetes, COPD, or kidney issues. This method offers a higher success rate than traditional steel wire closure.
Area of Science:
- Cardiovascular Surgery
- Thoracic Surgery
- Wound Healing
Background:
- Median sternotomy is a common approach for open heart surgery.
- Sternal dehiscence is a serious complication following sternotomy.
- Optimizing sternum closure techniques is crucial for patient outcomes.
Purpose of the Study:
- To evaluate the clinical efficacy of different sternum closure methods after open heart surgery.
- To identify risk factors associated with sternal dehiscence.
- To compare the outcomes of various sternal closure techniques.
Main Methods:
- Retrospective analysis of 2,662 patients undergoing open heart surgery.
- Evaluation of sternum closure methods including steel wire, Flexigrip + steel wire, sternal cable, sternal band, and Robicsek.
- Investigation of the relationship between sternal dehiscence and comorbidities like diabetes, COPD, and impaired kidney function.
Main Results:
- Sternal dehiscence occurred in 96 patients, with high prevalence of diabetes (60%), impaired renal function (25%), and COPD (21%).
- The Flexigrip + steel wire combination showed an 88% success rate in dehiscence repair, compared to 76% for standard steel wire.
- The Flexigrip + steel wire combination significantly decreased sternal dehiscence risk versus classical steel wire.
- Vacuum-assisted closure devices aided wound drainage and accelerated healing.
Conclusions:
- The Flexigrip + steel wire combination is a superior sternum closure method, significantly reducing dehiscence risk.
- This method is particularly beneficial for patients with comorbidities such as diabetes mellitus, chronic obstructive pulmonary disease, and impaired kidney function.
- Effective sternum closure is vital for minimizing complications and improving recovery after open heart surgery.
