title: Combined use of single and double-cross steel wires for closure of midline sternotomy.
abstract: BACKGROUND
  We describe an improved technique for sternal closure which is performed using combined single and double-cross steel wires. We made a mechanical study of these single and double-cross shapes considering the effects of applied transverse and longitudinal shearing forces.
  
  
  METHODS
  We used this technique in 80 patients who underwent coronary surgery with the use of bilateral internal mammary arteries.
  
  
  RESULTS
  Among them no major wound complications occurred, and in all cases a firm stabilization of the sternum was achieved.
  
  
  CONCLUSIONS
  We therefore consider this technique of sternal closure easy, safe and effective, also in patients considered at risk for sternal dehiscence.
authors.affiliation: Institute for Thoracic and Cardiovascular Surgery, University of Siena, Italy.
authors.forename: M A
authors.initials: MA
authors.lastname: Mariani
authors.forename: G
authors.initials: G
authors.lastname: Vaccari
authors.forename: A
authors.initials: A
authors.lastname: Marullo
authors.forename: G
authors.initials: G
authors.lastname: Cevenini
authors.forename: A
authors.initials: A
authors.lastname: Tripodi
authors.forename: G
authors.initials: G
authors.lastname: Lisi
authors.forename: G
authors.initials: G
authors.lastname: Mazzesi
authors.forename: B
authors.initials: B
authors.lastname: Mezzacapo
authors.forename: G
authors.initials: G
authors.lastname: Sani
authors.forename: M
authors.initials: M
authors.lastname: Toscano
mesh_terms: D001864:Bone Wires; D001026:Coronary Artery Bypass / Q000379:methods; D003327:Coronary Disease / Q000601:surgery; D006801:Humans; D012189:Retrospective Studies; D012449:Safety; D013232:Steel; D013249:Sternum / Q000601:surgery*; D013536:Suture Techniques / Q000295:instrumentation*; D013908:Thoracotomy; D016896:Treatment Outcome