scholarly journals Initial Report of a New Suture Cerclage Tape for Sternal Closure

2021 ◽  
Author(s):  
Paul DiGiorgi
Keyword(s):  
Wound Infection ◽  
Bone Fractures ◽  
Steel Wire ◽  
Long Bone ◽  
Deep Sternal Wound Infection ◽  
Sternal Wound Infection ◽  
Initial Report ◽  
Sternal Closure ◽  
Measurable Amount ◽  
Wire Cerclage

PURPOSE: We sought to evaluate a new, flexible suture cerclage tape for sternal closure after cardiac surgery. DESCRIPTION: Fiber Tape (Arthrex, Naples, FL, USA) suture cerclage has been successfully utilized in the stabilization of long bone fractures. For sternal closure, it is placed similarly to wire cerclage. Uniquely, it allows a measurable amount of tension to be applied to the sternum and it is at least twice as strong as stainless steel wire. We hypothesized this new flexible tape would provide short term safety and efficacy, as measured by incidence of deep sternal wound infection. EVALUATION: We performed a retrospective, single center analysis of adult patients undergoing sternotomy closure with FT. The observed incidence of deep sternal wound infection (DSWI) was compared to the expected incidence calculated through the Society of Thoracic Surgery (STS) risk calculator. A total of 45 patients were closed with FT. No patients suffered DSWI. Thirty of the 45 patients had STS risk calculations. For these 30 patients, the expected rate of DSWI was 0.2%. CONCLUSIONS: Despite study limitations, FT appears to be a safe method for sternal closure.

scholarly journals Improved results of the vacuum assisted closure and Nitinol clips sternal closure after postoperative deep sternal wound infection

2009 ◽  
Vol 35 (5) ◽  
pp. 833-838 ◽  
Author(s):  
Maria Pia Tocco ◽  
Alberto Costantino ◽  
Milva Ballardini ◽  
Claudio D’Andrea ◽  
Marcello Masala ◽  
...  
Keyword(s):  
Wound Infection ◽  
Deep Sternal Wound Infection ◽  
Sternal Wound Infection ◽  
Vacuum Assisted Closure ◽  
Sternal Closure

Wire Cerclage Versus Cable Closure After Sternotomy for Dehiscence and DSWI: A Systematic Review and Meta-Analysis

2020 ◽  
Vol 15 (4) ◽  
pp. 322-328
Author(s):  
Apurva Dixit ◽  
Derrick Y. Tam ◽  
Monica Yu ◽  
Bobby Yanagawa ◽  
Mario Gaudino ◽  
...  
Keyword(s):  
Systematic Review ◽  
Wound Infection ◽  
Meta Analysis ◽  
Median Sternotomy ◽  
Deep Sternal Wound Infection ◽  
Sternal Wound Infection ◽  
Sternal Dehiscence ◽  
Wire Cerclage ◽  
Lower Pain ◽  
Potential Alternative

Objective Cable closure has been introduced as a potential alternative to traditional wire cerclage (WC) for closure of median sternotomy. To evaluate whether cable closure improves patient outcomes, we conducted a systematic review and meta-analysis of the literature. Methods Ovid versions of Medline and Embase, and Google Scholar were used for the literature search. This yielded 7 studies ( n = 2,758), which compared traditional WC to cable closure systems. Outcomes included deep sternal wound infection, sternal dehiscence, postoperative pain score, and sternal wound infection. Results We found significantly lower incidence of sternal dehiscence for cable closure compared to WC (risk ratio [RR] 0.14, 95% confidence interval [CI]: 0.03 to 0.59 , P < 0.01 , I 2 = 0%) but no difference in DSWI (RR 0.97, 95% CI: 0.39 to 2.42, P = 0.95, I 2 = 33%). Cable closure was also associated with lower pain when compared with the WC group (mean difference −1.04 points, 95% CI: −1.89 to −0.19 , P = 0.02, I 2 = 87%). Conclusions This study suggests that cable closure results in less incidence of sternal dehiscence and pain compared to WC. Nonetheless, there remains a limited number of studies on this topic and further high-quality studies are required to confirm the results of this meta-analysis.

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