Annals of thoracic and cardiovascular surgery : official journal of the Association of Thoracic and Cardiovascular Surgeons of Asia · 2012
The use of Nitinol clips for primary sternal closure in cardiac surgery.
СтатьяНазвание и аннотация: Перевод в очереди
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Nikolaidis Nicolas, Karangelis Dimos, Mattam Kavitha, Tsang Geoffrey, Ohri Sunil
Аннотация
PURPOSE: Deep sternal wound complications after cardiac surgery have an incidence of 2 to 8% and carry a significant mortality. The aim of this study was to evaluate the effect of thermo-reactive Nitinol clips on the incidence of postoperative deep sternal wound complications.
METHODS: We retrospectively reviewed 1119 consecutive patients that underwent major cardiac surgery via median sternotomy in our centre. Sternal closure was performed using Nitinol clips in 235 patients (Group I) and standard stainless steel wires in 884 patients (Group II). The risk factors that were identified between the two groups were age, EuroSCORE, body mass index, diabetes and pulmonary comorbidity.
RESULTS: The overall incidence of deep sternal wound complications was 2.2% (25/1119).The incidence was higher in Group II (2.3%) compared to Group I (1.7%) (p = 0?8).Mechanical sternal dehiscence occurred in 2 patients in Group II. Mortality related to sternal wound complications was 8% (2/21) in Group II whereas in Group I was 0%.
CONCLUSION: The incidence of sternal wound complications and the mortality related to them were lower in patients undergoing sternal closure with Nitinol clips. A randomized study to further evaluate the possible advantages of Nitinol clips is warranted.
METHODS: We retrospectively reviewed 1119 consecutive patients that underwent major cardiac surgery via median sternotomy in our centre. Sternal closure was performed using Nitinol clips in 235 patients (Group I) and standard stainless steel wires in 884 patients (Group II). The risk factors that were identified between the two groups were age, EuroSCORE, body mass index, diabetes and pulmonary comorbidity.
RESULTS: The overall incidence of deep sternal wound complications was 2.2% (25/1119).The incidence was higher in Group II (2.3%) compared to Group I (1.7%) (p = 0?8).Mechanical sternal dehiscence occurred in 2 patients in Group II. Mortality related to sternal wound complications was 8% (2/21) in Group II whereas in Group I was 0%.
CONCLUSION: The incidence of sternal wound complications and the mortality related to them were lower in patients undergoing sternal closure with Nitinol clips. A randomized study to further evaluate the possible advantages of Nitinol clips is warranted.