title: A new proposal of skin-closure system for median sternotomy: usefulness and cosmetic results analysis of MEDIZIP Surgical Zipper in neoplastic immuno-compromised patients.
abstract: OBJECTIVE
  The authors evaluate the effectiveness and the cosmetic results obtained using the new skin closing system MEDIZIP Surgical Zipper in oncological immuno-compromised patients submitted to median sternotomy.
  
  
  METHODS
  In our Institute, from 1999 to 2002, MEDIZIP was used to close the sternal wounds in 45 patients undergoing median sternotomy for bilateral metastasectomy, It took about half a minute (mean time: 32.00 +/- 11.48 sec) to perform the application. To evaluate the cosmetic results, a three-level scale was conceived: level 1: very good, level 2: satisfactory, level 3: inadequate.
  
  
  RESULTS
  Overall forty-two 20 cm-long zippers were used, two 25 cm-long and one 30 cm-long. MEDIZIP remained in situ for an average of 9.98 +/- 2.23 days (median: 9 days; range: 8-13 days). The average time taken for inspection was 70.00 +/- 2.48 sec (median: 70, range: 45-130) and the zipper was removed in a few seconds. No wound infections were observed. We classified 39 patients at level 1 (very good, 87%), and 6 at level 2 (satisfactory, 13%).
  
  
  CONCLUSIONS
  MEDIZIP can be considered an effective skin-closure system which is easily and quickly handled and assures good cosmetic results with non-invasive removal; it proves particularly useful in pediatric patients and in adults affected by neoplastic diseases and undergoing multiple combined anti-cancer treatments.
authors.affiliation: Oncologic Thoracic Surgery, Istituto Nazionale Tumori, Milan, Italy. ppbm@virgilio.it
authors.forename: Pier Paolo
authors.initials: PP
authors.lastname: Brega-Massone
authors.forename: Cosimo
authors.initials: C
authors.lastname: Lequaglie
authors.forename: Barbara
authors.initials: B
authors.lastname: Magnani
authors.forename: Ignazio
authors.initials: I
authors.lastname: Cataldo
mesh_terms: D000328:Adult; D002648:Child; D003357:Cosmetic Techniques / Q000295:instrumentation*; D062109:Dermatologic Surgical Procedures; D006801:Humans; D007902:Length of Stay; D019651:Plastic Surgery Procedures / Q000379:methods*; D013249:Sternum / Q000601:surgery*; D013525:Surgical Instruments / Q000592:standards; D013536:Suture Techniques; D014945:Wound Healing