1Department of Cardiac Surgery, University Medical Centre Maribor, Maribor, Slovenia; 2Faculty of Medicine, University of Maribor, Maribor, Slovenia; 3Department of Infectious Disease and Febrile Conditions, University Medical Centre Maribor, Maribor, Slovenia.
Acta Clin Croat. 2022 Feb;60(3):435-440. doi: 10.20471/acc.2021.60.03.14.
Although there has been a trend towards minimally invasive and sternum-sparing procedures, median sternotomy is still a standard surgical approach in cardiac surgery. Many techniques and innovations for closure of sternal osteotomy have been developed with contradictory results. In this report, we present our first experience with the nitinol-made sternal closure system in the primary, as well as secondary closure of sternal osteotomy. A small series of 20 patients had their sternotomy closed with Flexigrip clips. In one case, the Flexigrip clips were used in secondary wound closure in a patient with deep sternal wound infection after full sternotomy and coronary bypass surgery. After 6-month follow-up, all patients were doing well with their sternums clinically stable and the sternotomy wounds completely healed. In conclusion, Flexigrip clips offered a stable alternative to steel wires in primary, as well as secondary sternal closure. Moreover, in secondary sternal closure, the thermoactive clips offered safety advantages over the standard wire cerclage technique because the need for dissection of the substernal adhesions could be avoided.
尽管微创手术和胸骨保留术的趋势日益明显，但正中开胸术仍然是心脏外科的标准手术方法。许多胸骨切开术闭合的技术和创新已经得到了发展，但结果却相互矛盾。在本报告中，我们首次报告了在原发性和继发性胸骨切开术闭合中使用镍钛诺制成的胸骨闭合系统的经验。20 例患者的胸骨切开术采用 Flexigrip 夹闭合。在 1 例患者中，在完全正中切开和冠状动脉旁路手术后发生深部胸骨伤口感染的患者中，使用 Flexigrip 夹进行继发性伤口闭合。6 个月随访时，所有患者胸骨均稳定，临床状况良好，胸骨切开术伤口完全愈合。总之，Flexigrip 夹在原发性和继发性胸骨闭合中提供了一种稳定的替代钢丝的选择。此外，在继发性胸骨闭合中，热激活夹比标准钢丝环扎技术具有安全优势，因为可以避免切开胸骨下粘连。
