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改善心脏手术中的胸骨闭合效果:聚乙烯缝合带与钢丝的比较。

Improving Sternal Closure Outcomes in Cardiac Surgery: Polyethylene Suture Tapes vs. Steel Wires.

作者信息

Khalpey Zain, Kumar Ujjawal Aditya, Aslam Usman, Phillips Tyler, Khalpey Zacharya, Cooper Anthony, Riley Robert

机构信息

Department of Cardiac Surgery, HonorHealth, 10210 N 92nd St, Scottsdale, AZ 85258, USA.

Khalpey AI Lab, Applied and Translational AI Research Institute (ATARI), 10210 N 92nd St, Scottsdale, AZ 85258, USA.

出版信息

J Clin Med. 2025 Jan 6;14(1):277. doi: 10.3390/jcm14010277.

Abstract

Steel wires are often inadequate for sternal closure for patients at high risk of sternal complications. This study compares a novel sternal closure system to conventional steel wires to assess its potential to reduce sternal complication rates and improve clinical outcomes. A retrospective study was conducted on 300 consecutive patients undergoing cardiac surgery via median sternotomy. A total of 150 patients underwent steel wire sternal closure, while 150 underwent suture tape closure. Preoperative, intraoperative, and postoperative data were collected and analyzed for both groups. Rates of sternal wound infections (1% vs. 5%, = 0.0363) and sternal dehiscence (0% vs. 5%, = 0.0297) were lower in the suture tape group. Suture tape patients had significantly less pain at 14 and 30 days ( = 0.0002 and 0.0071). The requirement for sternal protection adjuncts was eliminated with suture tape closure. Sternal closure time was significantly shorter in the suture tape group (11 vs. 19 min, < 0.0001). Suture tapes proved safe, feasible, and effective for sternal closure, demonstrating significant advantages for sternal closure over steel wires, with reduced rates of sternal dehiscence, infection, postoperative incisional pain, and closure time. These superior outcomes and the elimination of sternal protection adjuncts can potentially reduce healthcare costs. Our experiences suggest that this novel sternal closure system has significant potential, with larger prospective studies warranted to optimize sternal closure strategies.

摘要

对于有较高胸骨并发症风险的患者,钢丝通常不足以用于胸骨闭合。本研究将一种新型胸骨闭合系统与传统钢丝进行比较,以评估其降低胸骨并发症发生率和改善临床结局的潜力。对300例连续接受正中胸骨切开术的心脏手术患者进行了一项回顾性研究。共有150例患者接受钢丝胸骨闭合,而150例接受缝合带闭合。收集并分析了两组患者的术前、术中和术后数据。缝合带组的胸骨伤口感染率(1%对5%,P = 0.0363)和胸骨裂开率(0%对5%,P = 0.0297)较低。缝合带组患者在术后14天和30天时疼痛明显减轻(P = 0.0002和0.0071)。使用缝合带闭合可消除对胸骨保护辅助装置的需求。缝合带组的胸骨闭合时间明显更短(11分钟对19分钟,P < 0.0001)。缝合带被证明用于胸骨闭合是安全、可行且有效的,显示出在胸骨闭合方面相对于钢丝具有显著优势,可降低胸骨裂开、感染、术后切口疼痛和闭合时间的发生率。这些优异的结果以及对胸骨保护辅助装置的消除可能会降低医疗成本。我们的经验表明,这种新型胸骨闭合系统具有巨大潜力,需要进行更大规模的前瞻性研究以优化胸骨闭合策略。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/70f9/11720976/180e2fb9d9d0/jcm-14-00277-g001.jpg

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