Skip to main content
Erschienen in:

25.03.2023 | Original Article

A prospective randomized controlled study to assess the effectiveness of super FIXSORB WAVE® for sternal stabilization after sternotomy

verfasst von: Kiyotoshi Oishi, Hirokuni Arai, Hidehito Kuroki, Tomoyuki Fujioka, Makoto Tomita, Dai Tasaki, Keiji Oi, Eiki Nagaoka, Tatsuki Fujiwara, Masashi Takeshita, Tomoya Yoshizaki, Takeshi Someya, Tomohiro Mizuno

Erschienen in: General Thoracic and Cardiovascular Surgery | Ausgabe 11/2023

Einloggen, um Zugang zu erhalten

Abstract

Background

We developed a new sternal fixation device, Super FIXSORB WAVE®, a corrugated plate made of u-HA/PLLA, to improve sternal stability after sternotomy. This present study aimed to evaluate the new device clinically.

Methods

This prospective, single-blinded, multicenter trial randomized 69 patients to either wire cerclage only (group C, n = 30) or wire cerclage plus Super FIXSORB WAVE® (group W, n = 39). The primary endpoint was a degree of sternal displacement at six months. Displacement of the sternal halves in the anteroposterior and lateral directions was measured using computed tomography horizontal section images at the third costal and fourth intercostal levels. The secondary endpoints were sternal pain and quality-of-life over 6 months.

Results

Group W showed significantly reduced sternal anteroposterior displacement at both the third costal (0 [0–1.9] mm vs. 1.1 [0–2.1] mm; P = 0.014) and fourth intercostal (0 [0–1.0] mm) vs. 1.0 [0–1.8] mm; P = 0.015) levels than group C. In group W, lateral displacement was suppressed without a significant increase from 2 weeks to 6 months, while it increased in group C. There was no significant difference in postoperative sternal pain and quality-of-life between the two groups. No adverse events, such as infection, inflammation, or foreign body reaction, were observed with this device.

Conclusions

Using Super FIXSORB WAVE®, sternal displacement was significantly suppressed in both the anteroposterior and lateral directions. The use of this device results in safe and easy sternal reinforcement without any adverse events, and sternal healing can be accelerated.

Clinical trial registry number

This study was registered in the Japan Registry of Clinical Trials (February 21, 2019; jRCTs032180146).
Anhänge
Nur mit Berechtigung zugänglich
Literatur
1.
Zurück zum Zitat Robicsek F, Fokin A, Cook J, Bhatia D. Sternal instability after midline sternotomy. Thorac Cardiovasc Surg. 2000;48(1):1–8.CrossRefPubMed Robicsek F, Fokin A, Cook J, Bhatia D. Sternal instability after midline sternotomy. Thorac Cardiovasc Surg. 2000;48(1):1–8.CrossRefPubMed
2.
Zurück zum Zitat Losanoff JE, Richman BW, Jones JW. Disruption and infection of median sternotomy: a comprehensive review. Eur J Cardiothorac Surg. 2002;21(5):831–9.CrossRefPubMed Losanoff JE, Richman BW, Jones JW. Disruption and infection of median sternotomy: a comprehensive review. Eur J Cardiothorac Surg. 2002;21(5):831–9.CrossRefPubMed
3.
Zurück zum Zitat Pinotti KF, Cataneo DC, Rodrigues OR, Cataneo AJM. Closure of the sternum with anchoring of the steel wires: systematic review and meta-analysis. J Thorac Cardiovasc Surg. 2018;156(1):178–86.CrossRefPubMed Pinotti KF, Cataneo DC, Rodrigues OR, Cataneo AJM. Closure of the sternum with anchoring of the steel wires: systematic review and meta-analysis. J Thorac Cardiovasc Surg. 2018;156(1):178–86.CrossRefPubMed
4.
Zurück zum Zitat Shafi AMA, Abuelgasim E, Abuelgasim B, Iddawela S, Harky A. Sternal closure with single compared with double or figure of 8 wires in obese patients following cardiac surgery: a systematic review and meta-analysis. J Card Surg. 2021;36(3):1072–82.CrossRefPubMed Shafi AMA, Abuelgasim E, Abuelgasim B, Iddawela S, Harky A. Sternal closure with single compared with double or figure of 8 wires in obese patients following cardiac surgery: a systematic review and meta-analysis. J Card Surg. 2021;36(3):1072–82.CrossRefPubMed
5.
Zurück zum Zitat Schimmer C, Sommer SP, Bensch M, Bohrer T, Aleksic I, Leyh R. Sternal closure techniques and postoperative sternal wound complications in elderly patients. Eur J Cardiothorac Surg. 2008;34(1):132–8.CrossRefPubMed Schimmer C, Sommer SP, Bensch M, Bohrer T, Aleksic I, Leyh R. Sternal closure techniques and postoperative sternal wound complications in elderly patients. Eur J Cardiothorac Surg. 2008;34(1):132–8.CrossRefPubMed
6.
Zurück zum Zitat Schimmer C, Reents W, Berneder S, et al. Prevention of sternal dehiscence and infection in high-risk patients: a prospective randomized multicenter trial. Ann Thorac Surg. 2008;86(6):1897–904.CrossRefPubMed Schimmer C, Reents W, Berneder S, et al. Prevention of sternal dehiscence and infection in high-risk patients: a prospective randomized multicenter trial. Ann Thorac Surg. 2008;86(6):1897–904.CrossRefPubMed
7.
Zurück zum Zitat Tamura K, Maruyama T, Sakurai S. Usefulness of sternal closure with bioresorbable plate in respiratory function after coronary artery bypass grafting. Gen Thorac Cardiovasc Surg. 2019;67(3):277–82.CrossRefPubMed Tamura K, Maruyama T, Sakurai S. Usefulness of sternal closure with bioresorbable plate in respiratory function after coronary artery bypass grafting. Gen Thorac Cardiovasc Surg. 2019;67(3):277–82.CrossRefPubMed
8.
Zurück zum Zitat Morimoto K, Matsushita T, Masuda S, Kurata A. The novel technique of sternal closure with absorbable mesh for osteoporotic patients. Heart Lung Circ. 2021;30(6):e65–7.CrossRefPubMed Morimoto K, Matsushita T, Masuda S, Kurata A. The novel technique of sternal closure with absorbable mesh for osteoporotic patients. Heart Lung Circ. 2021;30(6):e65–7.CrossRefPubMed
9.
Zurück zum Zitat Ando M. Effect of internal fixation of the sternum using bioabsorbable pins in small children. J Card Surg. 2019;34(10):983–7.CrossRefPubMed Ando M. Effect of internal fixation of the sternum using bioabsorbable pins in small children. J Card Surg. 2019;34(10):983–7.CrossRefPubMed
10.
Zurück zum Zitat Saito T, Iguchi A, Sakurai M, Kobayashi K. Biomechanical study of a poly-L-lactide (PLLA) sternal pin in sternal closure after cardiothoracic surgery. Ann Thorac Surg. 2004;77(2):684–7.CrossRefPubMed Saito T, Iguchi A, Sakurai M, Kobayashi K. Biomechanical study of a poly-L-lactide (PLLA) sternal pin in sternal closure after cardiothoracic surgery. Ann Thorac Surg. 2004;77(2):684–7.CrossRefPubMed
11.
Zurück zum Zitat Tsunekawa T, Usui A, Oshima H, et al. A bioresorbable osteosynthesis device can induce an earlier sternal fusion after median sternotomy. Interact Cardiovasc Thorac Surg. 2012;15(3):377–81.CrossRefPubMedPubMedCentral Tsunekawa T, Usui A, Oshima H, et al. A bioresorbable osteosynthesis device can induce an earlier sternal fusion after median sternotomy. Interact Cardiovasc Thorac Surg. 2012;15(3):377–81.CrossRefPubMedPubMedCentral
12.
Zurück zum Zitat Kuroki H, Arai H, Srisont S, Oi K, Tomita M, Mizuno T. Corrugated sheet of unsintered hydroxyapatite poly-L-lactide for sternal fixation: a preclinical study. Ann Thorac Cardiovasc Surg. 2020;26(1):40–6.CrossRefPubMed Kuroki H, Arai H, Srisont S, Oi K, Tomita M, Mizuno T. Corrugated sheet of unsintered hydroxyapatite poly-L-lactide for sternal fixation: a preclinical study. Ann Thorac Cardiovasc Surg. 2020;26(1):40–6.CrossRefPubMed
13.
Zurück zum Zitat Tam DY, Nedadur R, Yu M, Yanagawa B, Fremes SE, Friedrich JO. Rigid plate fixation versus wire cerclage for sternotomy after cardiac surgery: a meta-analysis. Ann Thorac Surg. 2018;106(1):298–304.CrossRefPubMed Tam DY, Nedadur R, Yu M, Yanagawa B, Fremes SE, Friedrich JO. Rigid plate fixation versus wire cerclage for sternotomy after cardiac surgery: a meta-analysis. Ann Thorac Surg. 2018;106(1):298–304.CrossRefPubMed
14.
Zurück zum Zitat Allen KB, Thourani VH, Naka Y, et al. Rigid plate fixation versus wire cerclage: patient-reported and economic outcomes from a randomized trial. Ann Thorac Surg. 2018;105(5):1344–50.CrossRefPubMed Allen KB, Thourani VH, Naka Y, et al. Rigid plate fixation versus wire cerclage: patient-reported and economic outcomes from a randomized trial. Ann Thorac Surg. 2018;105(5):1344–50.CrossRefPubMed
15.
Zurück zum Zitat Raman J, Lehmann S, Zehr K, et al. Sternal closure with rigid plate fixation versus wire closure: a randomized controlled multicenter trial. Ann Thorac Surg. 2012;94(6):1854–61.CrossRefPubMed Raman J, Lehmann S, Zehr K, et al. Sternal closure with rigid plate fixation versus wire closure: a randomized controlled multicenter trial. Ann Thorac Surg. 2012;94(6):1854–61.CrossRefPubMed
16.
Zurück zum Zitat Cataneo DC, Dos Reis TA, Felisberto G, Rodrigues OR, Cataneo AJM. New sternal closure methods versus the standard closure method: systematic review and meta-analysis. Interact Cardiovasc Thorac Surg. 2019;28(3):432–40.CrossRefPubMed Cataneo DC, Dos Reis TA, Felisberto G, Rodrigues OR, Cataneo AJM. New sternal closure methods versus the standard closure method: systematic review and meta-analysis. Interact Cardiovasc Thorac Surg. 2019;28(3):432–40.CrossRefPubMed
17.
Zurück zum Zitat Shikinami Y, Okuno M. Bioresorbable devices made of forged composites of hydroxyapatite (HA) particles and poly-L-lactide (PLLA): Part I basic characteristics. Biomater. 1999;20(9):859–77.CrossRef Shikinami Y, Okuno M. Bioresorbable devices made of forged composites of hydroxyapatite (HA) particles and poly-L-lactide (PLLA): Part I basic characteristics. Biomater. 1999;20(9):859–77.CrossRef
18.
Zurück zum Zitat Shikinami Y, Okuno M. Bioresorbable devices made of forged composites of hydroxyapatite (HA) particles and poly L-lactide (PLLA). Part II: practical properties of miniscrews and miniplates. Biomaterials. 2001;22(23):3197–211.CrossRefPubMed Shikinami Y, Okuno M. Bioresorbable devices made of forged composites of hydroxyapatite (HA) particles and poly L-lactide (PLLA). Part II: practical properties of miniscrews and miniplates. Biomaterials. 2001;22(23):3197–211.CrossRefPubMed
19.
Zurück zum Zitat Shikinami Y, Matsue Y, Nakamura T. The complete process of bioresorption and bone replacement using devices made of forged composites of raw hydroxyapatite particles/poly l-lactide (F-u-HA/PLLA). Biomaterials. 2005;26(27):5542–51.CrossRefPubMed Shikinami Y, Matsue Y, Nakamura T. The complete process of bioresorption and bone replacement using devices made of forged composites of raw hydroxyapatite particles/poly l-lactide (F-u-HA/PLLA). Biomaterials. 2005;26(27):5542–51.CrossRefPubMed
20.
Zurück zum Zitat Tugulan CI, Spindel SM, Bansal AD, Bates MJ, Parrino EP. Does elective sternal plating in morbidly obese patients reduce sternal complication rates? Ann Thorac Surg. 2020;110(6):1898–903.CrossRefPubMed Tugulan CI, Spindel SM, Bansal AD, Bates MJ, Parrino EP. Does elective sternal plating in morbidly obese patients reduce sternal complication rates? Ann Thorac Surg. 2020;110(6):1898–903.CrossRefPubMed
Metadaten
Titel
A prospective randomized controlled study to assess the effectiveness of super FIXSORB WAVE® for sternal stabilization after sternotomy
verfasst von
Kiyotoshi Oishi
Hirokuni Arai
Hidehito Kuroki
Tomoyuki Fujioka
Makoto Tomita
Dai Tasaki
Keiji Oi
Eiki Nagaoka
Tatsuki Fujiwara
Masashi Takeshita
Tomoya Yoshizaki
Takeshi Someya
Tomohiro Mizuno
Publikationsdatum
25.03.2023
Verlag
Springer Nature Singapore
Erschienen in
General Thoracic and Cardiovascular Surgery / Ausgabe 11/2023
Print ISSN: 1863-6705
Elektronische ISSN: 1863-6713
DOI
https://doi.org/10.1007/s11748-023-01928-5

Neu im Fachgebiet Chirurgie

Lohnt sich die Karotis-Revaskularisation?

Die medikamentöse Therapie für Menschen mit Karotisstenosen hat sich in den vergangenen Dekaden verbessert. Braucht es also noch einen invasiven Eingriff zur Revaskularisation der Halsschlagader bei geringem bis moderatem Risiko für einen ipsilateralen Schlaganfall?

Höhere Dosis von Dexamethason senkt Überlebenschancen

Personen mit Hirnmetastasen, die perioperativ höhere kumulative Dosen von Dexamethason erhalten, haben eine schlechtere Prognose. Um die Ergebnisse zu verbessern, bedarf es strengerer Dosierungsschemata.

Appendektomie erhält Remission bei Colitis ulcerosa

Wird der Wurmfortsatz bei Personen mit Colitis ulcerosa entfernt, ist die Rückfallrate um ein Drittel geringer als unter konservativer Behandlung. Auch die Lebensqualität verbessert sich und der Bedarf an Medikamenten nimmt ab.

Op.-Entscheidung bei Divertikulitis: Lebensqualität zählt!

Soll man Menschen, die schon mehrfach schmerzhafte Divertikulitisepisoden durchgemacht haben, eine Op. anbieten? Ein Team aus Helsinki rät, dies von der Lebensqualität abhängig zu machen.

Update Chirurgie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.