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Effective Technique of Sternum Closure in High-Risk Patients
Gideon Goldman, MD;
Roberto Nestel, MD;
Eitan Snir, MD;
Bernardo Vidne, MD
Arch Surg. 1988;123(3):386-387.
Abstract
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• A successful technique of closing the sternum in a selected group of poor-risk patients involves the combination of a mattress suture and a fixative single-wire suture, both of 0 stainless-steel monofilament. Our technique was used on 100 high-risk patients and compared with double control groups, one consisting of 200 normal-risk patients and the second of 100 high-risk patients. We found that the incidence of wound infections was reduced to 1% with our new technique compared with 3% and 1% in the control groups (the high- and normal-risk groups, respectively). There was neither dehiscence nor mediastinitis in the study group, compared with 1% and 0.5% incidences of these complications in the controls. Also, there was no mortality in the combined-closure group compared with mortality of 0.5% and 1% in the control groups. We believe that this closure effectively strengthens the complex of bone and wire, improving the stability of the chest by giving a correct axis to the sternum. It is also cost-effective and easy to perform and does not prolong operation time.
(Arch Surg 1988;123:386-387)
Author Affiliations
From the Department of Cardiovascular and Thoracic Surgery and Surgery A, Ichilov Hospital and Sackler School of Medicine, Tel Aviv, Israel.
Footnotes
Accepted for publication Feb 16, 1987.
Reprint requests to Department of Surgery A, Ichilov Hospital, 6 Weizman St, Tel Aviv 64239, Israel (Dr Goldman).
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