Primary closure of median sternotomy: techniques and principles.
Understanding the biomechanics of midline sternotomy repair is important to successful surgical outcome. High-risk patients, particularly those with immunosuppression, diabetes, and osteoporosis, should be identified. Details of technique should be monitored, and closure should incorporate lateral support of the sternum in patients at risk. Sternal dehiscence can occur under physiologic loads. Closure techniques and materials should insure stable repair, with avoidance of material migration through the bone.
Losanoff
Julian E
JE
Department of Surgery, M580 Health Sciences Center, University of Missouri School of Medicine, One Hospital Drive, Columbia, MO 65212, USA.
Jones
James W
JW
Richman
Bruce W
BW
D001698:Biomedical Engineering / Q000295:instrumentation / Q000379:methods; D001864:Bone Wires; D006801:Humans; D008480:Mediastinitis / Q000209:etiology; D008954:Models, Biological; D011183:Postoperative Complications; D012307:Risk Factors; D013249:Sternum / Q000098:blood supply / Q000601:surgery*; D013529:Surgical Wound Dehiscence; D013536:Suture Techniques / Q000295:instrumentation; D013537:Sutures