title: Sternal cables are not superior to traditional sternal wiring for preventing deep sternal wound infection.
abstract: Deep sternal wound infection is a devastating complication of cardiac surgery. In the current era of increasing patient comorbidity, newer techniques must be evaluated in attempts to reduce the rates of deep sternal wound infection.
  
  
  
  A randomized controlled trial comparing sternal closure with traditional sternal wires in figure-8 formation with the Pioneer cabling system® from Medigroup after adult cardiac surgery was performed.
  
  
  
  A total of 273 patients were enrolled with 137 and 135 patients randomized to sternal wires and cables group, respectively. Baseline characteristics between the two groups were well balanced. Deep sternal wound infection occurred in 0.7% of patients in the wires group and 3.7% of patients in the cables group (absolute risk difference = -3.0%, 95% confidence interval: -7.7 to 0.9%; P = 0.12). Patients in the cables group were extubated slightly earlier than those in the sternal wires group postoperatively (9.7 vs 12.8 h; P = 0.03). There was, however, no significant difference in hospital and follow-up pain scores or analgesia requirements.
  
  
  
  The Pioneer sternal cabling system appears to facilitate early extubation after adult cardiac surgery, but it does not reduce the rate of deep sternal infectionAustralian New Zealand Clinical Trials Registry: ANZCTR-ACTRN12615000973516.
authors.affiliation: Department of Cardiothoracic Surgery, Western Australian Cardiothoracic Research and Audit Group, Fiona Stanley Hospital, Perth, WA, Australia bendunne@icloud.com.
authors.forename: Ben
authors.initials: B
authors.lastname: Dunne
authors.affiliation: Department of Cardiothoracic Surgery, Western Australian Cardiothoracic Research and Audit Group, Fiona Stanley Hospital, Perth, WA, Australia.
authors.forename: Mark
authors.initials: M
authors.lastname: Murphy
authors.affiliation: Department of Cardiothoracic Surgery, Western Australian Cardiothoracic Research and Audit Group, Fiona Stanley Hospital, Perth, WA, Australia.
authors.forename: Rohen
authors.initials: R
authors.lastname: Skiba
authors.affiliation: Department of Cardiothoracic Surgery, Western Australian Cardiothoracic Research and Audit Group, Fiona Stanley Hospital, Perth, WA, Australia.
authors.forename: Xiao
authors.initials: X
authors.lastname: Wang
authors.affiliation: Department of Cardiothoracic Surgery, Western Australian Cardiothoracic Research and Audit Group, Fiona Stanley Hospital, Perth, WA, Australia.
authors.forename: Kwok
authors.initials: K
authors.lastname: Ho
authors.affiliation: Department of Cardiothoracic Surgery, Western Australian Cardiothoracic Research and Audit Group, Fiona Stanley Hospital, Perth, WA, Australia.
authors.forename: Robert
authors.initials: R
authors.lastname: Larbalestier
authors.affiliation: Department of Cardiothoracic Surgery, Western Australian Cardiothoracic Research and Audit Group, Fiona Stanley Hospital, Perth, WA, Australia.
authors.forename: Christopher
authors.initials: C
authors.lastname: Merry
mesh_terms: D001864:Bone Wires; D006348:Cardiac Surgical Procedures / Q000009:adverse effects*; D004867:Equipment Design; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011184:Postoperative Period; D019651:Plastic Surgery Procedures / Q000379:methods*; D016037:Single-Blind Method; D013249:Sternum / Q000601:surgery*; D013530:Surgical Wound Infection / Q000209:etiology / Q000517:prevention & control*; D016896:Treatment Outcome
keywords: Deep sternal wound infection; Median sternotomy; Sternal closure