Multifilament Cable Wire versus Conventional Wire for Sternal Closure in Patients Undergoing Major Cardiac Surgery.
BACKGROUND
Stainless steel wiring remains the most popular technique for primary sternal closure. Recently, a multifilament cable wiring system (Pioneer Surgical Technology Inc., Marquette, MI, USA) was introduced for sternal closure and has gained wide acceptance due to its superior resistance to tension. We aimed to compare conventional steel wiring to multifilament cable fixation for sternal closure in patients undergoing major cardiac surgery.


METHODS
Data were collected retrospectively on 1,354 patients who underwent sternal closure after major cardiac surgery, using either the multifilament cable wiring system or conventional steel wires between January 2009 and October 2010. The surgical outcomes of these two groups of patients were compared using propensity score matching based on 18 baseline patient characteristics.


RESULTS
Propensity score matching yielded 392 pairs of patients in the two groups whose baseline profiles showed no significant differences. No significant differences between the two groups were observed in the rates of early mortality (2.0% vs. 1.3%, p=0.578), major wound complications requiring reconstruction (1.3% vs. 1.3%, p>0.99), minor wound complications (3.6% vs. 2.0%, p=0.279), or mediastinitis (0.8% vs. 1.0%, p=1.00). Patients in the multifilament cable group had fewer sternal bleeding events than those in the conventional wire group, but this tendency was not statistically significant (4.3% vs. 7.4%, p=0.068).


CONCLUSIONS
The surgical outcomes of sternal closure using multifilament cable wires were comparable to those observed when conventional steel wires were used. Therefore, the multifilament cable wiring system may be considered a viable option for sternal closure in patients undergoing major cardiac surgery.
Department of Thoracic and Cardiovascular Surgery, Asan Medical Center, University of Ulsan College of Medicine.
You Na
YN
Oh
Department of Thoracic and Cardiovascular Surgery, Asan Medical Center, University of Ulsan College of Medicine.
Keong Jun
KJ
Ha
Department of Thoracic and Cardiovascular Surgery, Asan Medical Center, University of Ulsan College of Medicine.
Joon Bum
JB
Kim
Department of Thoracic and Cardiovascular Surgery, Asan Medical Center, University of Ulsan College of Medicine.
Sung-Ho
SH
Jung
Department of Thoracic and Cardiovascular Surgery, Asan Medical Center, University of Ulsan College of Medicine.
Suk Jung
SJ
Choo
Department of Thoracic and Cardiovascular Surgery, Asan Medical Center, University of Ulsan College of Medicine.
Cheol Hyun
CH
Chung
Department of Thoracic and Cardiovascular Surgery, Asan Medical Center, University of Ulsan College of Medicine.
Jae Won
JW
Lee
Cardiovascular surgery; Complication; Conventional wire; Multifilament cable wire; Sternal closure