title: Pericostal sutures to reinforce sternal closure after cardiac surgery.
abstract: OBJECTIVE
  An increasing number of elderly and medically complex patients are undergoing cardiac surgery and are at increased risk for sternal dehiscence. A technique of sternal closure reinforcement with pericostal wires is described, and results are reviewed.
  
  
  METHODS
  After placement of the standard peristernal wires, one or two sets of pericostal wires were placed around ribs in the mid-portion of the sternotomy to reinforce the closure. A retrospective study over a 6-year period was carried out to determine the incidence of sternal dehiscence and any associated complications. Pericostal wires were used in well over 50% of cases.
  
  
  RESULTS
  The incidence of sternal dehiscence was 4 out of 1048 operations (0.38%). No adverse effects of the pericostal wires were identified.
  
  
  CONCLUSIONS
  Frequent use of pericostal wires is associated with a low incidence of sternal dehiscence.
authors.affiliation: Georgetown University Medical Center, Washington, DC 20007, USA.
authors.forename: N M
authors.initials: NM
authors.lastname: Katz
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D017545:Aortic Aneurysm, Thoracic / Q000601:surgery; D001864:Bone Wires; D001026:Coronary Artery Bypass; D003327:Coronary Disease / Q000601:surgery; D005260:Female; D006331:Heart Diseases / Q000601:surgery*; D019918:Heart Valve Prosthesis Implantation; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D013249:Sternum / Q000601:surgery*; D013529:Surgical Wound Dehiscence / Q000517:prevention & control*; D013536:Suture Techniques; D016896:Treatment Outcome