HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to Personal Folders Download to citation manager Author home page(s): Jacob Zeitani Alfonso Penta de Peppo Antonio Scafuri Fabio Bertoldo Saverio Nardella Luigi Chiariello Permission Requests Citing Articles Citing Articles via HighWire Google Scholar Articles by Zeitani, J. Articles by Chiariello, L. PubMed PubMed Citation Articles by Zeitani, J. Articles by Chiariello, L. Related Collections Chest wall Related Article

---

Original Articles: General Thoracic

Performance of a Novel Sternal Synthesis Device After Median and Faulty Sternotomy: Mechanical Test and Early Clinical Experience

^a Department of Cardiac Surgery, Science and Technology, Tor Vergata University, Italy, Rome
^b Department of Science and Technology, Tor Vergata University, Italy, Rome
^c Department of Cardiac Surgery, Second University of Naples, Naples, Italy

Accepted for publication August 14, 2007.

^_* Address correspondence to Dr Zeitani, Division of Cardiac Surgery, Tor-Vergata University, Viale Oxford 85, Rome, 00133, Italy (Email: zeitani{at}hotmail.com).

Background: Reinforcement of chest closure may be required in patients with multiple risk factors of wound dehiscence. Performance of a light, size-adaptable closure reinforcement device (DSS: Sternal Synthesis Device; Mikai SpA, Vicenza, Italy) is presented.

Methods: A longitudinal median or paramedian incision was performed in artificial sternal models: closure was accomplished with simple interrupted steel wires or reinforced with the DSS. Forces required for separation of the rewired sternal halves during a monotonic tensile test were analyzed. A high velocity traction cycles test was also adopted to simulate the impact of coughing.

Results: After median incision, ultimate load values inducing break of the sternum models were 580 ± 35 N (Newton) in controls; failure of the test occurred at 1,200 ± 47 N in the reinforced group (p = 0.0002). More lateral displacement of sternal halves at increasing forces was observed in controls (p = 0.0001). After paramedian incision, ultimate load values inducing break of the constructs were lower in controls (220 ± 20 N vs 500 ± 25 N, p = 0.001), which also showed more lateral displacement of sternal halves than the reinforced group (p = 0.002). At the high velocity traction cycles test, the number of cycles required to break the models was lower in controls (2,250 ± 35 vs 3,855 ± 48 cycles, p = 0.0001). Preliminary clinical experience in 45 patients showed ease of implantation and low risk of complications.

Conclusions: The proposed sternal reinforcement device provides substantial sternal support at electromechanical testing after median and faulty sternotomy and may hopefully prevent sternal wires migration and bone fractures in high risk patients.

Related Article

Invited commentary

William D. Spotnitz
Ann. Thorac. Surg. 2008 85: 293. [Extract] [Full Text] [PDF]

This article has been cited by other articles:

				W. D. Spotnitz Invited commentary Ann. Thorac. Surg., January 1, 2008; 85(1): 293 - 293. [Full Text] [PDF]