title: Use of steel bands in sternotomy closure: implications in high-risk cardiac surgical population.
abstract: 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.
authors.affiliation: Cardiothoracic Surgery Service, Medellín Clinic, School of Medicine at CES University, Medellin, Colombia.
authors.forename: Sergio
authors.initials: S
authors.lastname: Franco
authors.forename: Ana M
authors.initials: AM
authors.lastname: Herrera
authors.forename: Mauricio
authors.initials: M
authors.lastname: Atehortúa
authors.forename: Luis
authors.initials: L
authors.lastname: Vélez
authors.forename: Juan
authors.initials: J
authors.lastname: Botero
authors.forename: Juan S
authors.initials: JS
authors.lastname: Jaramillo
authors.forename: Juan F
authors.initials: JF
authors.lastname: Vélez
authors.forename: Hugo
authors.initials: H
authors.lastname: Fernández
mesh_terms: D000368:Aged; D006348:Cardiac Surgical Procedures / Q000009:adverse effects*; D004867:Equipment Design; D005260:Female; D006801:Humans; D008297:Male; D008480:Mediastinitis / Q000209:etiology / Q000517:prevention & control; D008875:Middle Aged; D016017:Odds Ratio; D011446:Prospective Studies; D012189:Retrospective Studies; D018570:Risk Assessment; D013249:Sternum / Q000601:surgery*; D053831:Surgical Fixation Devices; D013529:Surgical Wound Dehiscence / Q000209:etiology / Q000517:prevention & control; D013530:Surgical Wound Infection / Q000209:etiology / Q000517:prevention & control; D013536:Suture Techniques / Q000295:instrumentation*; D016896:Treatment Outcome