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Use of steel bands in sternotomy closure: implications in high-risk cardiac surgical population

^a Cardiothoracic Surgery Service, Medellín Clinic, Cardiovascular Surgery Postgraduate Program, School of Medicine at CES University, Medellin, Colombia
^b Basic Science and Epidemiology Research, School of Medicine at CES University, Medellin, Colombia

*Corresponding author. Calle 10 #22-04, Universidad CES, Medellín, Colombia. Tel.: +(574)-4440555, ext: 327; fax: +(574)-2682876.

E-mail address: aherrera{at}ces.edu.co (A.M. Herrera).

A retrospective-prospective descriptive and comparative study of two sternal closure techniques in a population of 621 patients divided into: group A, steel band closure (n=300) and group B, conventional technique closure (n=321), was carried out between January 2005 and December 2007 in order to describe and compare the results of both techniques in high-risk patients for sternal dehiscence and mediastinitis. Differences between both groups and association with risk factors were obtained using non-parametric tests for statistical analysis. No complications or mortality related to the use of the steel sternal bands were found. A statistically significant difference was found in the frequency of sternal dehiscence between both groups (P=0.022) in favor of group A. Although the frequency of mediastinitis was higher in group B, a statistically significant difference could not be established in terms of this complication. Sternal dehiscence was found to be a risk factor for mediastinitis. This study demonstrates that the use of steel bands for median sternotomy closure is a safe, reliable and reproducible technique. The frequency of sternal dehiscence significantly decreases with this technique in high-risk patients.

Key Words: Cardiac surgical procedures; Sternum; Osteotomy; Surgical wound dehiscence; Mediastinitis