Pericostal sutures to reinforce sternal closure after cardiac surgery.

BACKGROUND AND AIM OF THE STUDY: An increasing number of elderly and medically complex patients are undergoing cardiac surgery and are at increased risk for sternal dehiscence. A technique of sternal closure reinforcement with pericostal wires is described, and results are reviewed.

METHODS

After placement of the standard peristernal wires, one or two sets of pericostal wires were placed around ribs in the mid-portion of the sternotomy to reinforce the closure. A retrospective study over a 6-year period was carried out to determine the incidence of sternal dehiscence and any associated complications. Pericostal wires were used in well over 50% of cases.

RESULTS

The incidence of sternal dehiscence was 4 out of 1048 operations (0.38%). No adverse effects of the pericostal wires were identified.

CONCLUSIONS

Frequent use of pericostal wires is associated with a low incidence of sternal dehiscence.