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Ann Thorac Surg 2007;83:1210-1212
© 2007 The Society of Thoracic Surgeons

How To Do It

New Transverse Plate Fixation System for Complicated Sternal Wound Infection After Median Sternotomy

Andre Plass, MDa,*, Jürg Grünenfelder, MDa, Oliver Reuthebuch, MDb, Robert Vachenauer, MDa, Jean-Marc Gauer, MDa, Gregor Zünd, MDc, Michele Genoni, MDa

a Clinic for Cardiovascular Surgery, University Hospital Zurich, Zurich, Switzerland
b Clinic for Cardiac Surgery, City Hospital Triemli, Zurich, Switzerland
c Department of Experimental Surgery, University Hospital Zurich, Zurich, Switzerland

Accepted for publication March 27, 2006.

* Address correspondence to Dr Plass, Clinic for Cardiovascular Surgery, University Hospital Zürich, Rämistr. 100, Zürich, CH-8091 Switzerland (Email: andreplass{at}aol.com).

Wire fixation after median sternotomy is a safe procedure, but it is still associated with potential wound infection including bony dehiscence. In case of infection and dehiscence the sternum is re-fixated with steel wires. If this is insufficient, then flap reconstruction would be another option. We describe an alternative way for complicated sternal closure by using a rigid sternal fixation system that is feasible for cardiac surgeons. Three patients suffering from sternal instability and infection were operated on with the new titanium plates. The procedures were uneventful and short-term follow-up showed stable sternal conditions. In this report the technical concept has been described in detail in 1 patient. This new sternal fixation technique is safe and easy to handle and broadens the spectrum for closure of complicated sternal wound infections or dehiscence.




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