title: Does removal of steel wires relieve post-sternotomy pain after cardiac surgery?
abstract: BACKGROUND
  Post-sternotomy pain in the absence of cardiac ischemia and sternal instability is most commonly due to the sternal wire sutures or a protruding wire. We performed a retrospective study to investigate the effect of removal of the steel wires for relief of post-sternotomy pain.
  
  
  METHODS
  All 206 patients who underwent sternal wire removal in our institution from January 2003 through August 2011 were included in this study. Alive patients were contacted by telephone to inquire about the fate of their pain. Accordingly, patients were classified into 4 groups: group 1 were free of symptoms; group 2 were satisfied, significantly better than before wire removal; group 3 had unchanged symptoms; and group 4 had worsening of pain after wire removal.
  
  
  RESULTS
  After excluding patients who died during the follow-up and those who had sternal instability and wound infection, 186 patients were available for the questionnaire. Complete relief of pain occurred in 83% of these patients, and 10% had improvement of their symptoms.
  
  
  CONCLUSIONS
  We recommend removal of the steel wires in patients with persistent chest pain after median sternotomy, when sternal instability, mediastinitis, and cardiac causes such as ischemia are excluded.
authors.affiliation: Department of Cardiothoracic Surgery, Catharina Hospital, Eindhoven, The Netherlands.
authors.forename: Sargul
authors.initials: S
authors.lastname: Rashidi
authors.forename: Ted Wo
authors.initials: TW
authors.lastname: Elenbaas
authors.forename: Mohamed A Soliman
authors.initials: MA
authors.lastname: Hamad
authors.forename: Hans J
authors.initials: HJ
authors.lastname: van Suijlekom
authors.forename: Albert Hm
authors.initials: AH
authors.lastname: van Straten
mesh_terms: D000368:Aged; D001864:Bone Wires; D006348:Cardiac Surgical Procedures; D020878:Device Removal; D004867:Equipment Design; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009426:Netherlands; D010147:Pain Measurement; D010149:Postoperative Pain / Q000175:diagnosis / Q000209:etiology / Q000601:surgery*; D012189:Retrospective Studies; D013232:Steel; D056346:Sternotomy / Q000009:adverse effects* / Q000295:instrumentation*; D011795:Surveys and Questionnaires; D016896:Treatment Outcome
chemical_list: D013232:Steel
keywords: Bone wires; cardiac surgical procedures; coronary artery bypass; pain; postoperative; sternotomy