XXXX with use of a peristernal cable-tie closure system: a retrospective case series.

@entity1 @entity281 @entity28 @entity2737
BACKGROUND: Deep sternal wound infections are a rare but serious complication after median sternotomy. We evaluated the incidence of @entity2737 associated with two techniques for sternal closure. METHODS: In this retrospective case series, we recorded the method of sternal closure in consecutive @entity1 undergoing a variety of cardiothoracic surgical procedures. Sternal closure in the historical control group was performed using trans-sternal, stainless-steel wire sutures; subsequent @entity1 were closed using wire sutures in conjunction with a novel, peristernal cable-tie closure system to reinforce the corpus sterni. Perioperative care was standardized between groups. Demographics, risk factors, and postoperative outcomes were analyzed. RESULTS: Between July 2010 and July 2014, 609 consecutive adult @entity1 underwent sternal closure following open median sternotomy at a single hospital in Mobile, Alabama. Sternal closure was accomplished with wire sutures in the first 309 @entity1 and with cable-tie reinforcement in the subsequent 300 @entity1 . Baseline characteristics were comparable between groups, except that the cable-tie group exhibited greater preoperative comorbidity. Mean body mass index was comparable between groups (30.2        6.6  kg/m(2) wire suture versus 30.5        7.7 cable-tie, p   =   0.568). Deep sternal wound @entity281 occurred in 2.6  % (8/309) @entity1 in the wire-suture group, whereas no deep sternal wound infections were observed in the cable tie group (p   =   0.008). CONCLUSIONS: The peristernal cable-tie system was a simple and reliable method for sternal closure after open median sternotomy, and was associated with a reduced risk of @entity2737 , even in an @entity28 and comorbid population.
