title: Avoidance of noninfectious sternal dehiscence: figure-of-8 wiring is superior to straight wire closure.
abstract: OBJECTIVE
  Comparison of figure-of-8 wiring or simple straight-wiring technique assessed by the frequency of early noninfectious sternal dehiscence.
  
  
  METHODS
  Observational register study with 7835 patients having sternal closure with figure-of-8 steel wires was compared with 2122 patients, where the sternotomy was closed by simple interrupted straight wires. The endpoint was the rate of early (within 30 days) sterile sternal dehiscence.
  
  
  RESULTS
  Fourteen patients (0.66%) with single wires and five patients (0.06%) with figure-of-8 wires underwent re-operation for nonmicrobial sternal disruption (p < 0.0001). The median time-point for re-intervention was 6 days for both groups. In more than 6000 patients, the sternotomy was closed with five figure-of-8 wires without dehiscence in any of them.
  
  
  CONCLUSIONS
  In a large cohort of consecutive cardiac operations, it was found that sternal closure with figure-of-8 wires is better than closure with simple interrupted wires.
authors.affiliation: Department of Cardiac Surgery, Feiring Heart Clinic, Feiring, Norway. sven.m.almdahl@unn.no
authors.forename: Sven M
authors.initials: SM
authors.lastname: Almdahl
authors.forename: Per
authors.initials: P
authors.lastname: Halvorsen
authors.forename: Terje
authors.initials: T
authors.lastname: Veel
authors.forename: Stein E
authors.initials: SE
authors.lastname: Rynning
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001864:Bone Wires / Q000009:adverse effects; D016009:Chi-Square Distribution; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012042:Registries; D012086:Reoperation; D056346:Sternotomy / Q000009:adverse effects; D013529:Surgical Wound Dehiscence; D013997:Time Factors; D016896:Treatment Outcome; D058106:Wound Closure Techniques / Q000009:adverse effects / Q000295:instrumentation*