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Related Experiment Videos

Biomechanical study of sternal closure techniques

W Cheng1, D E Cameron, K E Warden

  • 1Division of Cardiac Surgery, Johns Hopkins Medical Institutions, Baltimore, Maryland.

The Annals of Thoracic Surgery
|March 1, 1993
PubMed
Summary

Standard stainless steel wire closure offers superior sternal stability compared to band techniques. This finding is crucial for optimizing cardiothoracic surgical outcomes and patient recovery.

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Area of Science:

  • Biomedical Engineering
  • Thoracic Surgery
  • Materials Science

Background:

  • Median sternotomy is the standard surgical incision for cardiothoracic procedures.
  • Current closure methods, primarily parasternal wires, are being evaluated for improved stability.
  • Alternative closure techniques are being explored to enhance sternal fixation.

Purpose of the Study:

  • To compare the biomechanical stability of standard No. 5 stainless steel wire sternal closure with three alternative band closure methods.
  • To evaluate the efficacy of Mersilene ribbon, stainless steel band, and plastic band closures against traditional wire closure.
  • To determine the optimal sternal fixation technique for enhanced closure stability in cardiothoracic surgery.

Main Methods:

  • Eight bisected cadaver sterna were utilized for biomechanical testing.

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  • Each sternal fixation method (No. 5 stainless steel wire, 5-mm Mersilene ribbon, 5-mm stainless steel band, 5-mm plastic band) was applied.
  • A MTS Bionix 858 Biomechanical Tester applied distracting forces (50-200 N) to assess displacement and calculate fixation stability via regression analysis.

    • Main Results:

    • No. 5 stainless steel wire demonstrated the highest biomechanical stability, with the lowest mean slope (0.012 mm/Newton).
    • Plastic band (0.014 mm/Newton), Mersilene ribbon, and 5-mm steel band (both 0.017 mm/Newton) showed less stability.
    • The superior stability of stainless steel wire is potentially attributed to the tension generated by twisting the wires.

    Conclusions:

    • Standard No. 5 stainless steel wire closure provides superior biomechanical stability compared to the tested band closure methods.
    • While all methods showed linear displacement, wire closure offered the most robust fixation.
    • Further investigation into the mechanical properties of sternal closure techniques can optimize surgical practice.