| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ARCHIVE | SEARCH | TABLE OF CONTENTS |
|
|
|
|||||||
|
|||||||||
The Annals of Thoracic Surgery, Vol 55, 737-740, Copyright © 1993 by The Society of Thoracic Surgeons
W Cheng, DE Cameron, KE Warden, JD Fonger and VL Gott
Median sternotomy is the most commonly used incision in cardiothoracic
surgery. Closure of this incision is usually performed with parasternal
wires, but alternate techniques have been proposed to improve closure
stability. This study compares biomechanical stability of standard wire
(No. 5 stainless steel) with that of three types of band closure: 5-mm
Mersilene ribbon, 5-mm stainless steel band, and 5-mm plastic band. Eight
bisected cadaver sterna were reapproximated using each method of sternal
fixation and tested for biomechanical stability using an MTS Bionix 858
Biomechanical Tester. Loads of 50, 100, 150, and 200 Newtons (1 Newton = 1
kg.m/s2) were applied as a distracting force across the closure. A linear
regression line of displacement as a function of increasing load was
determined for each closure method; the slope of this line is inversely
proportional to fixation stability. Displacement and load correlated
linearly for each closure (r = 0.99). Mean slopes were 0.012 mm/Newton (95%
confidence limits, 0.0098 to 0.0142 mm/Newton) for No. 5 stainless steel
wire, 0.014 mm/Newton (95% confidence limits, 0.0118 to 0.0162 mm/Newton)
for plastic band, 0.017 mm/Newton (95% confidence limits, 0.0148 to 0.0192
mm/Newton) for Mersilene ribbon, and 0.017 mm/Newton (95% confidence
limits, 0.0148 to 0.0192 mm/Newton) for 5-mm steel band. No. 5 stainless
steel wire provided the most stable closure, although statistical
significance was achieved only in comparison with Mersilene ribbon and
stainless steel band (p < 0.05). The superior stability of stainless
steel wire closure may be due to tightening of the wires by twisting, which
results in more tension across the reapproximated sternal halves than with
other methods.
ARTICLES
Biomechanical study of sternal closure techniques
Division of Cardiac Surgery, Johns Hopkins Medical Institutions, Baltimore, Maryland.
This article has been cited by other articles:
|
|
 |
|
  S. Bhattacharya, I. Sau, M. Mohan, K. Hazari, R. Basu, and A. Kaul Sternal Bands for Closure of Midline Sternotomy Leads to Better Wound Healing Asian Cardiovasc Thorac Ann, February 1, 2007; 15(1): 59 - 63. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 A.-H. Kiessling, F. Isgro, U. Weisse, A. Moltner, W. Saggau, and J. Boldt Advanced Sternal Closure to Prevent Dehiscence in Obese Patients Ann. Thorac. Surg., October 1, 2005; 80(4): 1537 - 1539. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
S. Pai, N. J. Gunja, E. L. Dupak, N. L. McMahon, T. P. Roth, J. F. Lalikos, R. M. Dunn, N. Francalancia, G. D. Pins, and K. L. Billiar In Vitro Comparison of Wire and Plate Fixation for Midline Sternotomies Ann. Thorac. Surg., September 1, 2005; 80(3): 962 - 968. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
R. Bruhin, U. A. Stock, J.-P. Drucker, T. Azhari, J. Wippermann, J. M. Albes, D. Hintze, S. Eckardt, C. Konke, and T. Wahlers Numerical Simulation Techniques to Study the Structural Response of the Human Chest Following Median Sternotomy Ann. Thorac. Surg., August 1, 2005; 80(2): 623 - 630. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
U. K. Dasika and J. A. Magovern Lower sternal reinforcement to improve median sternotomy closure: Reply Ann. Thorac. Surg., June 1, 2004; 77(6): 2261 - 2262. [Full Text] [PDF]
|
|
|
|
|
|
T. Saito, A. Iguchi, M. Sakurai, and K. Tabayashi Biomechanical study of a Poly-L-Lactide (PLLA) sternal pin in sternal closure after cardiothoracic surgery Ann. Thorac. Surg., February 1, 2004; 77(2): 684 - 687. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
J. E. Losanoff, A. D. Collier, C. C. Wagner-Mann, B. W. Richman, H. Huff, F.-h. Hsieh, A. Diaz-Arias, and J. W. Jones Biomechanical comparison of median sternotomy closures Ann. Thorac. Surg., January 1, 2004; 77(1): 203 - 209. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
R. Sharma, D. Puri, B. P. Panigrahi, and I. S. Virdi A modified parasternal wire technique for prevention and treatment of sternal dehiscence Ann. Thorac. Surg., January 1, 2004; 77(1): 210 - 213. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
W. E. McGregor, M. Payne, D. R. Trumble, K. M. Farkas, and J. A. Magovern Improvement of sternal closure stability with reinforced steel wires Ann. Thorac. Surg., November 1, 2003; 76(5): 1631 - 1634. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
A. R. Casha and M. Gauci Mechanical comparison of three sternotomy closure techniques using a polyurethane foam sternal model Ann. Thorac. Surg., June 1, 2003; 75(6): 2009 - 2010. [Full Text] [PDF]
|
|
|
|
|
|
U. K. Dasika, D. R. Trumble, and J. A. Magovern Lower sternal reinforcement improves the stability of sternal closure Ann. Thorac. Surg., May 1, 2003; 75(5): 1618 - 1621. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 S. Glennie, D. E.T. Shepherd, and R. S. Jutley Strength of wired sternotomy closures: effect of number of wire twists Interactive CardioVascular and Thoracic Surgery, March 1, 2003; 2(1): 3 - 5. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 D. H. Pelsue, E. Monnet, J. S. Gaynor, B. E. Powers, K. Halling, D. Parker, and A. Golden Closure of Median Sternotomy in Dogs: Suture Versus Wire J. Am. Anim. Hosp. Assoc., November 1, 2002; 38(6): 569 - 576. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 A. Negri, J. Manfredi, A. Terrini, G. Rodella, G. Bisleri, S. El Quarra, and C. Muneretto Prospective evaluation of a new sternal closure method with thermoreactive clips Eur. J. Cardiothorac. Surg., October 1, 2002; 22(4): 571 - 575. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
A.R. Casha, M. Gauci, L. Yang, M. Saleh, P.H. Kay, and G.J. Cooper Fatigue testing median sternotomy closures Eur. J. Cardiothorac. Surg., March 1, 2001; 19(3): 249 - 253. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M. M. Puc, C. H. Antinori, D. T. Villanueva, M. Tarnoff, and J. A. Heim Ten-year experience with Mersilene-reinforced sternal wound closure Ann. Thorac. Surg., July 1, 2000; 70(1): 97 - 99. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 W. E. McGregor, D. R. Trumble, and J. A. Magovern MECHANICAL ANALYSIS OF MIDLINE STERNOTOMY WOUND CLOSURE J. Thorac. Cardiovasc. Surg., June 1, 1999; 117(6): 1144 - 1149. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
A.R. Casha, L. Yang, P.H. Kay, M. Saleh, and G.J. Cooper A biomechanical study of median sternotomy closure techniques Eur. J. Cardiothorac. Surg., March 1, 1999; 15(3): 365 - 369. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
W. Ozaki, S. R. Buchman, M. D. Iannettoni, and E. P. Frankenburg Biomechanical Study of Sternal Closure Using Rigid Fixation Techniques in Human Cadavers Ann. Thorac. Surg., June 1, 1998; 65(6): 1660 - 1665. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
K. D. Murray and M. K. Pasque Routine Sternal Closure Using Six Overlapping Figure-of-8 Wires Ann. Thorac. Surg., December 1, 1997; 64(6): 1852 - 1854. [Abstract] [Full Text]
|
|
|
|
|
|
H. S Soroff, A. R. Hartman, E. Pak, D. H Sasvary, and S. B Pollak Improved Sternal Closure Using Steel Bands: Early Experience With Three-Year Follow-up Ann. Thorac. Surg., April 1, 1996; 61(4): 1172 - 1176. [Abstract] [Full Text]
|
|
| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ARCHIVE | SEARCH | TABLE OF CONTENTS |
| ANN THORAC SURG | ASIAN CARDIOVASC THORAC ANN | EUR J CARDIOTHORAC SURG |
| J THORAC CARDIOVASC SURG | ICVTS | ALL CTSNet JOURNALS |
