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  • Title: Comparison of figure-of-eight and simple wire sternal closure techniques in patients with non-microbial sternal dehiscence.
    Author: Tekümit H, Cenal AR, Tataroğlu C, Uzun K, Akinci E.
    Journal: Anadolu Kardiyol Derg; 2009 Oct; 9(5):411-6. PubMed ID: 19819794.
    Abstract:
    OBJECTIVE: Sternal dehiscence is a serious and potentially devastating complication. The present study compared the effects of two sternal closure techniques, simple wire technique and figure-of-eight technique, on the development and outcome of non-microbial sternal dehiscence. METHODS: Medical records of all adult patients (n=6211) that underwent cardiac operations in our clinic through median sternotomy between January 2002 and August 2008 were retrospectively reviewed for the development of non-microbial sternal dehiscence. The outcomes of 90 (1.44%) isolated on-pump coronary artery bypass surgery (CABG) cases that developed dehiscence were analyzed with Student's t test, Mann Whitney U test, Chi-square test and Fisher's Exact test according to the type of sternal closure: figure-of-eight or simple wire technique. Survival analysis was made with Kaplan Meier test. RESULTS: Figure-of-eight and simple wire technique were associated with similar rates of sternal dehiscence (1.46% and 1.43%, respectively). In addition, after the development of sternal dehiscence, these techniques were associated with similar mortality rates and postoperative outcomes (time to sternal re-fixation, prolonged ICU stay, intraaortic balloon counterpulsation use and chest re-exploration inotropic agent use and postoperative cerebrovascular accident). One patient died in each group (2.6% vs. 1.9%, respectively). CONCLUSION: In conclusion, present findings suggest that the most commonly used sternal closure techniques, figure-of-eight technique and simple wire technique, may have similar outcomes in terms of development and prognosis of non-microbial dehiscence in patient undergoing isolated on-pump CABG operations.
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