» Articles » PMID: 37509585

Combined Band and Plate Fixation As a New Individual Option for Patients at Risk of Sternal Complications After Cardiac Surgery: A Single-Center Experience

Overview
Journal Biomedicines
Date 2023 Jul 29
PMID 37509585
Authors
Affiliations
Soon will be listed here.
Abstract

Due to the advent of interventional therapies for low- and intermediate-risk patients, case complexity has increased in cardiac surgery over the last decades. Despite the surgical progress achieved to keep up with the increase in the number of high-risk patients, the prevention of sternal complications remains a challenge requiring new, individualized sternal closure techniques. The aim of this study was to evaluate the safety and feasibility, as well as the in-hospital and long-term outcomes, of enhanced sternal closure with combined band and plate fixation using the new SternaLock 360 (SL360) system as an alternative to sternal wiring. From 2020 to 2022, 17 patients underwent enhanced sternal closure using the SL360 at our institution. We analyzed perioperative data, as well as clinical and radiologic follow-up data. The results were as follows: In total, 82% of the patients were treated with the SL360 based on perioperative risk factors, while in 18% of cases, the SL360 was used for secondary closure due to sternal instability. No perioperative complications were observed. We obtained the follow-up data of 82% of the patients (median follow-up time: 141 (47.8 to 511.5) days), showing no surgical revision, no sternal instability, no deep wound infections, and no sternal pain at the follow-up. In one case, a superficial wound infection was treated with antibiotics. In conclusion, enhanced sternal closure with the SL360 is easy to perform, effective, and safe. This system might be considered for both primary and secondary sternal closure in patients at risk of sternal complications.

Citing Articles

First Report on Rigid Plate Fixation for Enhanced Sternal Closure in Minimally Invasive Cardiac Surgery: Safety and Outcomes.

Miazza J, Reuthebuch B, Bruehlmeier F, Camponovo U, Maguire R, Koechlin L Bioengineering (Basel). 2025; 11(12.

PMID: 39768097 PMC: 11673957. DOI: 10.3390/bioengineering11121280.


Expansion bone allografts for anterior chest wall reconstruction after persistent sternal nonunion.

Shawwaf K, Sell-Dottin K, Farina J, Zeineddine R, Lackey J, Jaroszewski D JTCVS Tech. 2024; 27:199-201.

PMID: 39478903 PMC: 11518957. DOI: 10.1016/j.xjtc.2024.07.013.

References
1.
Andreas M, Muckenhuber M, Hutschala D, Kocher A, Thalhammer F, Vogt P . Direct sternal administration of Vancomycin and Gentamicin during closure prevents wound infection. Interact Cardiovasc Thorac Surg. 2017; 25(1):6-11. DOI: 10.1093/icvts/ivx032. View

2.
Miclau T, Martin R . The evolution of modern plate osteosynthesis. Injury. 1997; 28 Suppl 1:A3-6. DOI: 10.1016/s0020-1383(97)90109-1. View

3.
Wu L, Renucci J, Song D . Sternal nonunion: a review of current treatments and a new method of rigid fixation. Ann Plast Surg. 2004; 54(1):55-8. DOI: 10.1097/01.sap.0000139564.37314.1f. View

4.
Cogan J . Pain management after cardiac surgery. Semin Cardiothorac Vasc Anesth. 2010; 14(3):201-4. DOI: 10.1177/1089253210378401. View

5.
Coltro P, Farina Junior J . The role of the unilateral pectoralis major muscle flap in the treatment of deep sternal wound infection and dehiscence. J Card Surg. 2022; 37(8):2315-2316. DOI: 10.1111/jocs.16564. View