Comparison of sternum closure techniques with sternal cable and simple wire after open heart surgery

Abstract

Objective: Median sternotomy is the most commonly used method for open heart surgery. Poor sternal healing after median sternotomy can cause a significant increase in morbidity and mortality and prolong hospital stay. Although several techniques are available for sternal closure, it is practically limited, and the most common technique is the simple wire technique. There is insufficient scientific study on the comparison of alternative techniques. The aim of the present study was to compare the follow-up results of the sternotomy closure techniques: sternal cable and simple wire. Materials and Methods: Overall, 246 (141 male and 105 female) adult patients who underwent sternotomy closure with sternal cable (99) and simple wire (147) after open heart surgery were examined retrospectively. Patients' postoperative length of hospitalization, sternal dehiscence, local infection, mediastinitis, and mortality rates were evaluated. Resternotomy requirement due to sternal decomposition and surgical site infections was also evaluated. Statistical comparisons were made in terms of the parameters mentioned above. Results: When the groups were compared in terms of age, gender, diabetes mellitus (DM), chronic obstructive pulmonary disease (COPD), chronic renal failure (CRF), and smoking status, there was no statistically significant difference (p>0.05). The percentage of the patients' coronary artery bypass grafting+mitral valve replacement (9.09%) was higher (p=0.028) in the sternal cable group than in the simple wire group. The cross-clamp time was longer in the sternal cable group (81.24±31.91) than in the simple wire group (74.08±17.67) (p=0.044). Conclusion: Postoperative complications in the sternal cable group were less frequent but statistically not significant in our study. According to our results, sternal cable is effective and can be used as a good alternative to simple wire.