Rashidi Sargul, Elenbaas Ted Wo, Hamad Mohamed A Soliman, van Suijlekom Hans J, van Straten Albert Hm
Department of Cardiothoracic Surgery, Catharina Hospital, Eindhoven, The Netherlands.
Asian Cardiovasc Thorac Ann. 2013 Aug;21(4):409-13. doi: 10.1177/0218492312454278. Epub 2013 Jul 1.
Post-sternotomy pain in the absence of cardiac ischemia and sternal instability is most commonly due to the sternal wire sutures or a protruding wire. We performed a retrospective study to investigate the effect of removal of the steel wires for relief of post-sternotomy pain.
All 206 patients who underwent sternal wire removal in our institution from January 2003 through August 2011 were included in this study. Alive patients were contacted by telephone to inquire about the fate of their pain. Accordingly, patients were classified into 4 groups: group 1 were free of symptoms; group 2 were satisfied, significantly better than before wire removal; group 3 had unchanged symptoms; and group 4 had worsening of pain after wire removal.
After excluding patients who died during the follow-up and those who had sternal instability and wound infection, 186 patients were available for the questionnaire. Complete relief of pain occurred in 83% of these patients, and 10% had improvement of their symptoms.
We recommend removal of the steel wires in patients with persistent chest pain after median sternotomy, when sternal instability, mediastinitis, and cardiac causes such as ischemia are excluded.
在无心肌缺血和胸骨不稳定的情况下，胸骨切开术后疼痛最常见的原因是胸骨钢丝缝线或突出的钢丝。我们进行了一项回顾性研究，以调查去除钢丝对缓解胸骨切开术后疼痛的效果。
本研究纳入了2003年1月至2011年8月在我院接受胸骨钢丝取出术的所有206例患者。通过电话联系存活患者，询问其疼痛情况。据此，将患者分为4组：第1组无症状；第2组满意，比取出钢丝前明显好转；第3组症状无变化；第4组取出钢丝后疼痛加重。
排除随访期间死亡的患者以及有胸骨不稳定和伤口感染的患者后，186例患者可进行问卷调查。这些患者中83%的疼痛完全缓解，10%的患者症状有所改善。
我们建议，在排除胸骨不稳定、纵隔炎和缺血等心脏原因后，对正中胸骨切开术后持续胸痛的患者取出钢丝。
