Comparison between Figure of Eight Trans-Sternal and Figure of Eight Peri-Sternal Wiring In Median Sternotomy Closure
Journal Title: IOSR Journal of Dental and Medical Sciences (IOSR-JDMS) - Year 2019, Vol 18, Issue 4
Abstract
Midline sternotomy is established as the gold standard for variety of open heart operations. Sternal dehiscence after the operation is recognized devastating complication. The established closure technique uses steel wires in either figure 8 or simple interrupted suturing methods. In this typical technique, the steel wires are pushed across the each half of sternum. However peristernal and pericostal placement appears to reduce sternal damage, many surgeons use trans-sternal figure 8 wires for sternal fixation. In this study we have compare between peristernal and trans-sternal wiring. 50 cases selected prospectively. Fifty patients undergoing elective cardiac surgery via complete median sternotomy at a single institution were randomly assigned. The groups were well matched. In 25 cases sternal closer was done by three figure of eight transsternal wiring and in another 25 cases by three figure of eight peristernum wiring. Post operatively comparison was done for pain over sternum, peristernal collection/discharge, and sternal dehiscence, by examining patients at time of discharge, three month follow up and six month follow up. Our study suggest that peristernal wire technique provide better sternal stability than trans-sternal technique. Two patients in trans-sternal wiring group have complained of clicking and pain at sternum because of sternal instability
Authors and Affiliations
Dr. Giriraj Garg, Dr. Ishant Singla, Dr. Rajkumar Yadav
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