Sternal closure with sandwiched three-piece bioresorbable mesh

Background Median sternotomy is the most performed procedure in cardiac surgery; however, sternal displacement and bleeding remains a problem. This study aimed to investigate whether sternal reconstruction using a sandwiched three-piece bioresorbable mesh plate can prevent postoperative sternal displacement and bleeding more than a bioresorbable pin. Methods Patients (n = 218) who underwent median sternotomy were classified according to whether a sandwiched three-piece bioresorbable mesh plate and wire cerclage (group M, n = 109) or a bioresorbable pin and wire cerclage (group P, n = 109) were used during sternal reconstruction. The causes of postoperative sternal displacement and bleeding with computed tomography data were analyzed and compared between the groups. Results The preoperative patient characteristics did not significantly differ between the groups. However, the evaluation of sternal and substernal hematoma on postoperative day 5 using computed tomography showed sternal displacement in 4 (4%) and 22 (20%) patients, and substernal hematoma in 17 (16%) and 41 (38%) patients in groups M and P, respectively; this difference was significant. Furthermore, the amount of bleeding at 6 h postoperatively was lower in group M than in group P (235 ± 147 vs. 284 ± 175 mL, p = 0.0275). Chest reopening, intubation time, and length of intensive care unit and hospital stays did not differ between the groups. The evaluation of substernal hematoma based on computed tomography yielded a significantly lower for group M than for group P, revealing that the mesh plate was an independent predictor of substernal hematoma prevention. Conclusion Sternal fixation with a three-piece bioresorbable mesh plate could prevent postoperative sternal displacement, bleeding, and substernal hematoma more than sternal fixation with a pin.

Tissue Engineered Heart Valves: Autologous Cell Seeding on Biodegradable Polymer Scaffold - Shinoka - 2002 - Artificial Organs - Wiley Online Library

US20190125475A1 - Positive shaft rotation lock activated by jaw closure - Google Patents

Three-dimensional (3D)-reconstruction of a sternum dehiscence.

Analysis of the sternum for sternal closure with bioabsorbable sternal pins - Masashi Kawamura, Takafumi Masai, Hajime Matsue, Yasushi Yoshikawa, Yoshiki Sawa, 2013

A prospective randomized controlled study to assess the effectiveness of super FIXSORB WAVE® for sternal stabilization after sternotomy

Usefulness of sternal closure with bioresorbable plate in respiratory function after coronary artery bypass grafting

Sternal semi-closure using a bioresorbable osteosynthesis device: a new method for delayed sternal closure

Kayo Sugiyama's research works Aichi Medical University and other places

How to perform sternal closure with sandwiched three-piece mesh plate.