Kuşçu Yusuf, Amanvermez Şenarslan Dilşad, İşkesen Ahmet İhsan
Department of Cardiovascular Surgery, Manisa Celal Bayar Univeristy, Faculty of Medicine, Manisa, Türkiye.
Turk Gogus Kalp Damar Cerrahisi Derg. 2024 Dec 31;32(4 Suppl 2):069-70. doi: 10.5606/tgkdc.dergisi.2024.msb-44. eCollection 2024 Nov.
This study aimed to investigate the clinical results of sternum closure methods after open heart surgery with median sternotomy.
This retrospective study screened 2,662 patients who underwent open heart surgery. Classical steel wire, Flexigrip + steel wire combination, sternal cable, sternal band, and Robicsek were used as sternum closure methods in patients. The causality relationships of sternal dehiscence, diabetes mellitus, chronic obstructive pulmonary disease, impaired kidney function, and demographic characteristics of the patients were investigated.
Ninety-six patients developed dehiscence, and 60% of them had diabetes, 25% had impaired renal function, and 21% had chronic obstructive pulmonary disease. The treatment success rate was 88% when using the Flexigrip + steel wire combination in patients undergoing sternal dehiscence repair, and the treatment success rate was 76% using a standard steel wire. The combination of Flexigrip + steel wire significantly reduced the risk of sternal dehiscence compared to the use of classical steel wire in sternal closure. Vacuum-assisted closure devices were beneficial in draining wounds and shortened the healing time.
Flexigrip + steel wire combination in sternal closure significantly reduced the risk of sternal dehiscence in patients with diabetes mellitus, chronic obstructive pulmonary disease, and impaired kidney function.
本研究旨在探讨正中开胸心脏手术后胸骨闭合方法的临床效果。
这项回顾性研究筛选了2662例行心脏直视手术的患者。患者的胸骨闭合方法采用经典钢丝、Flexigrip+钢丝组合、胸骨缆线、胸骨带和罗比克塞克法。研究了胸骨裂开、糖尿病、慢性阻塞性肺疾病、肾功能损害与患者人口统计学特征之间的因果关系。
96例患者发生胸骨裂开，其中60%患有糖尿病，25%肾功能受损，21%患有慢性阻塞性肺疾病。在胸骨裂开修复患者中使用Flexigrip+钢丝组合时治疗成功率为88%，使用标准钢丝时治疗成功率为76%。与在胸骨闭合中使用经典钢丝相比，Flexigrip+钢丝组合显著降低了胸骨裂开的风险。负压封闭引流装置有利于伤口引流并缩短愈合时间。
在胸骨闭合中使用Flexigrip+钢丝组合可显著降低糖尿病、慢性阻塞性肺疾病和肾功能损害患者的胸骨裂开风险。
