Department of Cardiac Surgery, Aichi Medical University Hospital Yazakokarimata, Nagakute, Aichi, Japan.
Heart Surg Forum. 2022 Feb 25;25(1):E147-E151. doi: 10.1532/hsf.4443.
Several authors have investigated various sternal closure materials and technologies for sternal fixation; nonetheless, the optimal technique for primary sternal closure remains unclear. This study aimed to evaluate the sternal stability of a simple technique using a mesh-type plate (Super Fixorb MX40®; Takiron Co. Ltd., Osaka, Japan), as compared with wire cerclage.
A total of 70 patients who underwent cardiovascular surgery through median sternotomy between July 2019 and May 2020 were included. Two pieces of mesh-type plates were placed under the sternum in combination with wiring. The technique for sternal closure was randomly applied, which was mainly based on the surgeon's preferences: mesh plate (mesh group: N = 33) or conventional wire cerclage (wire group: N = 37). Sternal displacement was measured using computed tomography at discharge.
Pain scale scores and analgesic use on postoperative day 7 were similar between the two groups. However, the displacement in both the anterior-posterior and lateral directions was significantly smaller in the mesh group.
The use of the mesh plate device for sternal closure is simple, safe, easy, and potentially reliable without anterior-posterior sternal displacement.
已有多位作者研究了多种胸骨固定用的胸骨闭合材料和技术,但胸骨的初次闭合的最佳技术仍不明确。本研究旨在比较使用网片型板(Super Fixorb MX40®;Takiron Co. Ltd.,日本大阪)的简单技术与钢丝环扎技术的胸骨稳定性。
本研究纳入了 2019 年 7 月至 2020 年 5 月间接受正中胸骨切开术的心血管手术患者共 70 例。胸骨下联合布线放置两片网片型板。胸骨闭合技术随机应用,主要基于外科医生的偏好:网片板(网片组:N=33)或传统钢丝环扎(钢丝组:N=37)。出院时使用计算机断层扫描测量胸骨移位。
两组术后第 7 天的疼痛评分和镇痛药物使用情况相似。然而,网片组在前后和侧方的移位明显更小。
使用网片板装置进行胸骨闭合操作简单、安全、容易,且胸骨前后移位的潜在风险小,可靠性高。