Prospective, randomized, controlled trial of polymer cable ties versus standard wire closure of midline sternotomy.
J Thorac Cardiovasc Surg
; 156(4): 1589-1595.e1, 2018 10.
Article
in En
| MEDLINE
| ID: mdl-29778340
ABSTRACT
OBJECTIVE:
Midline sternotomy remains the most common access incision for cardiac operations. Traditionally, the sternum is closed with stainless steel wires. Wires are well known to stretch and break, however, leading to pain, nonunion, and potential deep sternal wound infection. We hypothesized that biocompatible plastic cable ties would achieve a more rigid sternal fixation, reducing postoperative pain and analgesia requirements.METHODS:
A prospective, randomized study compared the ZIPFIX (De Puy Synthes, West Chester, Pa) sternal closure system (n = 58) with standard stainless steel wires (n = 60). Primary outcomes were pain and analgesia requirements in the early postoperative period. Secondary outcome was sternal movement, as assessed by ultrasound at the postoperative follow-up visit.RESULTS:
Groups were well matched in demographic and operative variables. There were no significant differences between groups in postoperative pain, analgesia, or early ventilatory requirements. Patients in the ZIPFIX group had significantly more movement in the sternum and manubrium on ultrasound at 4 weeks.CONCLUSIONS:
ZIPFIX sternal cable ties provide reliable closure but no demonstrable benefit in this study in pain or analgesic requirements relative to standard wire closure after median sternotomy.Key words
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Polymers
/
Stainless Steel
/
Biocompatible Materials
/
Bone Wires
/
Sternotomy
/
Wound Closure Techniques
Type of study:
Clinical_trials
/
Etiology_studies
/
Observational_studies
Limits:
Aged
/
Female
/
Humans
/
Male
/
Middle aged
Country/Region as subject:
Oceania
Language:
En
Journal:
J Thorac Cardiovasc Surg
Year:
2018
Type:
Article