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胸骨闭合术的简易技术:使用可吸收网片板。

The Simple Technique of Sternal Closure Using An Absorbable Mesh Plate.

机构信息

Department of Cardiac Surgery, Aichi Medical University Hospital Yazakokarimata, Nagakute, Aichi, Japan.

出版信息

Heart Surg Forum. 2022 Feb 25;25(1):E147-E151. doi: 10.1532/hsf.4443.

Abstract

BACKGROUND

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.

METHODS

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.

RESULTS

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.

CONCLUSIONS

The use of the mesh plate device for sternal closure is simple, safe, easy, and potentially reliable without anterior-posterior sternal displacement.

摘要

背景

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。

方法

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。

结果

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。

结论

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。

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