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March 1988

Effective Technique of Sternum Closure in High-Risk Patients

Author Affiliations

From the Department of Cardiovascular and Thoracic Surgery and Surgery A, Ichilov Hospital and Sackler School of Medicine, Tel Aviv, Israel.

Arch Surg. 1988;123(3):386-387. doi:10.1001/archsurg.1988.01400270126021

• 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)