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Improved sternal fixation in the transsternal bilateral thoracotomy incision
R P Brown1, D S Esmore, C Lawson
1National Heart and Lung Replacement Service/Baker Institute, Alfred Hospital, Melbourne, Australia.
The Journal of Thoracic and Cardiovascular Surgery
|July 1, 1996
Summary
A novel titanium device for sternal fixation after bilateral lung transplantation significantly reduces sternal disruption. This innovative approach offers a superior alternative to traditional sternal wires, improving patient recovery.
Area of Science:
- Thoracic Surgery
- Cardiovascular Surgery
- Biomedical Engineering
Background:
- Bilateral sequential single-lung transplantation frequently utilizes a transsternal bilateral thoracotomy incision.
- Traditional sternal wire closure of the transverse sternotomy is associated with high disruption rates (20-40%), leading to complications like pain, deformity, delayed recovery, and infection.
Purpose of the Study:
- To introduce and evaluate a novel device for secure sternal fixation following transverse sternotomies.
- To overcome the limitations of conventional sternal closure methods in lung transplantation.
Main Methods:
- A novel titanium fixation device was designed, featuring anterior and posterior plates secured by screws into threaded posts.
- The device accommodates varying sternal thicknesses with adjustable post lengths.
- The device was implanted in 20 patients undergoing bilateral lung transplantation.
Main Results:
- Preliminary results indicate the device provides sound sternal fixation.
- The technique appears superior to traditional sternal wire closure for transverse sternotomies.
Conclusions:
- The novel titanium sternal fixation device offers a promising solution to reduce sternal disruption after bilateral lung transplantation.
- Further routine use is supported by preliminary findings, potentially improving patient outcomes and recovery.