title: Modified Transverse Thoracosternotomy and Cost-Effective Reinforced Sternal Closure.
abstract: The bilateral transverse thoracosternotomy clamshell incision provides excellent exposure to the mediastinal structures in double lung transplantation. The use of a modified transverse sternotomy and a figure of 8 configuration with one monofilament metal wire, along with two longitudinal wires across the sternal division, results in greater stability and equally distributed oblique tension. Our described technique was more cost effective and resulted in no incidence of dehiscence. We present our experience using a modified transverse sternotomy and reinforced sternal closure method.
authors.affiliation: Lung Transplant Program, Columbia University Medical Center, New York, New York.
authors.forename: Joseph
authors.initials: J
authors.lastname: Costa
authors.affiliation: Lung Transplant Program, Columbia University Medical Center, New York, New York.
authors.forename: Joshua R
authors.initials: JR
authors.lastname: Sonett
authors.affiliation: Lung Transplant Program, Columbia University Medical Center, New York, New York. Electronic address: fd2133@cumc.columbia.edu.
authors.forename: Frank
authors.initials: F
authors.lastname: D'Ovidio
mesh_terms: D001864:Bone Wires; D003362:Cost-Benefit Analysis; D006801:Humans; D016040:Lung Transplantation; D056346:Sternotomy / Q000379:methods*; D013529:Surgical Wound Dehiscence / Q000517:prevention & control*; D013908:Thoracotomy / Q000379:methods*; D058106:Wound Closure Techniques / Q000191:economics* / Q000295:instrumentation