title: Sternal closure by rigid plate fixation in off-pump coronary artery bypass grafting: a comparative study.
abstract: Sternal instability or dehiscence results in serious sternal wound infection. We sought to assess the early outcomes with such a plating system for sternal closure in comparison to the conventional wiring technique in off-pump coronary artery bypass grafting (CABG). Patients who underwent off-pump CABG were enrolled. Thirty-one patients received plate sternal fixation. A total of 64 patients who underwent off-pump CABG by a single surgeon at our hospital from July 2013 to December 2014 were enrolled. Thirty-one patients received plate sternal fixation (Plate group), while 33 received conventional wire closure (Wire group). The early outcomes, including the pain score and analgesic usage count were compared. Dietary intake was also recorded to assess the duration of appetite loss. At discharge, the largest sternal displacement was measured on computed tomography. In the Plate group, the pain scores were significantly lower on post-operative day 5-8 and POD 9-12 from those in the Wire group. The analgesic usage count on POD 9-12 was significantly lower in the Plate group. The duration of appetite loss and hospital stay was significantly shorter in the Plate group. The displacement in both the anterior-posterior and lateral directions was significantly smaller in the Plate group. Sternal closure by rigid plate fixation contributes to a more rapid post-operative recovery through reduced pain.
authors.affiliation: Department of Cardiovascular Surgery, Tokyo Medical University Hospital, 6-7-1 Nishshinjuku Shinjyuku-ku, Tokyo, 160-0023, Japan. spgfs112@yahoo.co.jp.
authors.forename: Katsuhiko
authors.initials: K
authors.lastname: Matsuyama
authors.affiliation: Department of Cardiovascular Surgery, Tokyo Medical University Hospital, 6-7-1 Nishshinjuku Shinjyuku-ku, Tokyo, 160-0023, Japan.
authors.forename: Masahiko
authors.initials: M
authors.lastname: Kuinose
authors.affiliation: Department of Cardiovascular Surgery, Tokyo Medical University Hospital, 6-7-1 Nishshinjuku Shinjyuku-ku, Tokyo, 160-0023, Japan.
authors.forename: Nobusato
authors.initials: N
authors.lastname: Koizumi
authors.affiliation: Department of Cardiovascular Surgery, Tokyo Medical University Hospital, 6-7-1 Nishshinjuku Shinjyuku-ku, Tokyo, 160-0023, Japan.
authors.forename: Tomoaki
authors.initials: T
authors.lastname: Iwasaki
authors.affiliation: Department of Cardiovascular Surgery, Tokyo Medical University Hospital, 6-7-1 Nishshinjuku Shinjyuku-ku, Tokyo, 160-0023, Japan.
authors.forename: Kayo
authors.initials: K
authors.lastname: Toguchi
authors.affiliation: Department of Cardiovascular Surgery, Tokyo Medical University Hospital, 6-7-1 Nishshinjuku Shinjyuku-ku, Tokyo, 160-0023, Japan.
authors.forename: Hitoshi
authors.initials: H
authors.lastname: Ogino
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001860:Bone Plates; D001864:Bone Wires; D047549:Coronary Artery Bypass, Off-Pump; D005260:Female; D005593:Fracture Fixation, Internal / Q000379:methods*; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D056346:Sternotomy; D013249:Sternum / Q000601:surgery; D016896:Treatment Outcome
keywords: Coronary artery bypass grafting; Plate fixation; Sternal closure