Skip to main content
Erschienen in: Pediatric Cardiology 8/2019

23.09.2019 | Original Article

Reabsorbable Pins can Reinforce an Early Sternal Stability After Median Sternotomy in Young Children with Congenital Heart Disease

verfasst von: Chengming Fan, Mi Tang, Sijie Wu, Shuwen Yuan, Anton V. Borovjagin, Jinfu Yang

Erschienen in: Pediatric Cardiology | Ausgabe 8/2019

Einloggen, um Zugang zu erhalten

Abstract

We evaluated the efficacy of bioresorbable sternal reinforcement device (poly-l-lactide sternal pins) on sternal healing after median sternotomy in young children (with body weight less than 10 kg) with congenital heart disease (CHD). Data from 85 patients, who underwent CHD surgery through median sternotomy from October 2016 to May 2018, were collected and analyzed. Sternal pins were utilized in 85 patients (10 mm × 1 mm × 1 mm for patients with body weights less than 5 kg and 15 mm × 2 mm × 2 mm for those weighing between 5 and 10 kg) in addition to sternum closure with Ethicon PDSTMII running sutures (Group A), while 84 patients received the Ethicon sternal closure (Group B) with no pins. The occurrence of sternal dehiscence, anterior-posterior displacement, and high-low displacement was evaluated by physical examination and three-dimensional computed tomography at one month postoperatively. No anterior-posterior sternal displacement (0%) was observed in Group A, while 10 anterior-posterior displacements (11.9%) were observed in Group B (P < 0.01). The number of sternal caudal-cranial displacements in Groups A and B was 4 (4.71%) and 5 (5.35%), respectively (P = 0.870). While no sternal dehiscence (0%) was observed in Group A, 7 out of 84 patients (8.33%) in Group B exhibited obvious sternal dehiscence (P < 0.01). The bioresorbable poly-l-lactide sternal pins reduced an anterior-posterior sternal displacement and sternal dehiscence, which was accompanied by a significant improvement of an early sternal fixation.
Anhänge
Nur mit Berechtigung zugänglich
Literatur
1.
Zurück zum Zitat Hu CX, Tan J, Chen S, Ding H, Xu ZW (2014) Comparison of clinical outcomes and postoperative recovery between two open heart surgeries: minimally invasive right subaxillary vertical thoracomy and traditional median sternotomy. Asian Pac J Trop Med 7:625–629CrossRef Hu CX, Tan J, Chen S, Ding H, Xu ZW (2014) Comparison of clinical outcomes and postoperative recovery between two open heart surgeries: minimally invasive right subaxillary vertical thoracomy and traditional median sternotomy. Asian Pac J Trop Med 7:625–629CrossRef
2.
Zurück zum Zitat Keçeligil HT, Kolbakir F, Akar H, Konuralp C, Demir Z, Demirağ MK (2000) Sternal closure with resorbable synthetic loop suture material in children. J Pediatr Surg 35:1309–1311CrossRef Keçeligil HT, Kolbakir F, Akar H, Konuralp C, Demir Z, Demirağ MK (2000) Sternal closure with resorbable synthetic loop suture material in children. J Pediatr Surg 35:1309–1311CrossRef
3.
Zurück zum Zitat Usui A, Oshima H, Akita T, Ueda Y (2006) Polydioxane (PDS) cord has insufficient reliability to securely close the sternum. J Thorac Cardiovasc Surg 131:1174–1175CrossRef Usui A, Oshima H, Akita T, Ueda Y (2006) Polydioxane (PDS) cord has insufficient reliability to securely close the sternum. J Thorac Cardiovasc Surg 131:1174–1175CrossRef
4.
Zurück zum Zitat Luciani N, Anselmi A, Possati G (2006) Adjusting the indication to polydioxane suture for elective sternal closure. J Thorac Cardiovasc Surg 132:1243–1244CrossRef Luciani N, Anselmi A, Possati G (2006) Adjusting the indication to polydioxane suture for elective sternal closure. J Thorac Cardiovasc Surg 132:1243–1244CrossRef
5.
Zurück zum Zitat Yang XN, Pastorino U (2006) Are absorbable sutures inadequate to close the sternum? J Thorac Cardiovasc Surg 132:1503CrossRef Yang XN, Pastorino U (2006) Are absorbable sutures inadequate to close the sternum? J Thorac Cardiovasc Surg 132:1503CrossRef
6.
Zurück zum Zitat Oiwa H, Ishida R, Sudo K (2004) Sternal closure with reabsorbable pin and cord in pediatric-less invasive cardiac surgery. Ann Thorac Surg 78:358–359CrossRef Oiwa H, Ishida R, Sudo K (2004) Sternal closure with reabsorbable pin and cord in pediatric-less invasive cardiac surgery. Ann Thorac Surg 78:358–359CrossRef
7.
Zurück zum Zitat Negri A, Manfredi J, Terrini A et al (2002) Prospective evaluation of a new sternal closure method with thermoreactive clips. Eur J Cardiothorac Surg 22:571–575CrossRef Negri A, Manfredi J, Terrini A et al (2002) Prospective evaluation of a new sternal closure method with thermoreactive clips. Eur J Cardiothorac Surg 22:571–575CrossRef
8.
Zurück zum Zitat Tsunekawa T, Usui A, Oshima H et al (2012) A bioresorbable osteosynthesis device can induce an earlier sternal fusion after median sternotomy. Interact Cardiovasc Thorac Surg 15:377–381CrossRef Tsunekawa T, Usui A, Oshima H et al (2012) A bioresorbable osteosynthesis device can induce an earlier sternal fusion after median sternotomy. Interact Cardiovasc Thorac Surg 15:377–381CrossRef
9.
Zurück zum Zitat Subramaniam T, Keita L, Veerasingam D (2015) Sternal Talon, a novel repair for sternal dehiscence. Kardiochir Torakochirurgia Pol 12:153–154PubMedPubMedCentral Subramaniam T, Keita L, Veerasingam D (2015) Sternal Talon, a novel repair for sternal dehiscence. Kardiochir Torakochirurgia Pol 12:153–154PubMedPubMedCentral
10.
Zurück zum Zitat Song DH, Lohman RF, Renucci JD, Jeevanandam V, Raman J (2004) Primary sternal plating in high-risk patients prevents mediastinitis. Eur J Cardiothorac Surg 26:367–372CrossRef Song DH, Lohman RF, Renucci JD, Jeevanandam V, Raman J (2004) Primary sternal plating in high-risk patients prevents mediastinitis. Eur J Cardiothorac Surg 26:367–372CrossRef
11.
Zurück zum Zitat Bek EL, Yun KL, Kochamba GS, Pfeffer TA (2010) Effective median sternotomy closure in high risk open heart patients. Ann Thorac Surg 89:1317–1318CrossRef Bek EL, Yun KL, Kochamba GS, Pfeffer TA (2010) Effective median sternotomy closure in high risk open heart patients. Ann Thorac Surg 89:1317–1318CrossRef
12.
Zurück zum Zitat Steinmann C, Krille S, Mueller A, Weber P, Reingruber B, Martin A (2011) Pectus excavatum and pectus carinatum patients suffer from lower quality of life and impaired body image: a control group comparison of psychological characteristics prior to surgical correction. Eur J Cardiothorac Surg 40:1138–1145PubMed Steinmann C, Krille S, Mueller A, Weber P, Reingruber B, Martin A (2011) Pectus excavatum and pectus carinatum patients suffer from lower quality of life and impaired body image: a control group comparison of psychological characteristics prior to surgical correction. Eur J Cardiothorac Surg 40:1138–1145PubMed
13.
Zurück zum Zitat Coskun ZK, Turgut HB, Demirsoy S, Cansu A (2013) Clinical experience of repair of pectus excavatum and carinatum deformities. Cardiovasc J Afr 24:318–321CrossRef Coskun ZK, Turgut HB, Demirsoy S, Cansu A (2013) Clinical experience of repair of pectus excavatum and carinatum deformities. Cardiovasc J Afr 24:318–321CrossRef
14.
Zurück zum Zitat Schwab RJ, Hähnel JC, Paek S, Meisner H, Sebening F (1994) Sternal closure with resorbable synthetic suture material in children. Thorac Cardiovasc Surg 42:185–186CrossRef Schwab RJ, Hähnel JC, Paek S, Meisner H, Sebening F (1994) Sternal closure with resorbable synthetic suture material in children. Thorac Cardiovasc Surg 42:185–186CrossRef
15.
Zurück zum Zitat Kreitmann B, Riberi A, Metras D (1992) Evaluation of an absorbable suture for sternal closure in pediatric cardiac surgery. J Card Surg 7:254–256CrossRef Kreitmann B, Riberi A, Metras D (1992) Evaluation of an absorbable suture for sternal closure in pediatric cardiac surgery. J Card Surg 7:254–256CrossRef
16.
Zurück zum Zitat Oncel M, Tezcan B, Akyol KG, Dereli Y, Sunam GS (2015) Sternal closure with absorbable pins and cords in general thoracic surgery. Surg Today 45:929–931CrossRef Oncel M, Tezcan B, Akyol KG, Dereli Y, Sunam GS (2015) Sternal closure with absorbable pins and cords in general thoracic surgery. Surg Today 45:929–931CrossRef
Metadaten
Titel
Reabsorbable Pins can Reinforce an Early Sternal Stability After Median Sternotomy in Young Children with Congenital Heart Disease
verfasst von
Chengming Fan
Mi Tang
Sijie Wu
Shuwen Yuan
Anton V. Borovjagin
Jinfu Yang
Publikationsdatum
23.09.2019
Verlag
Springer US
Erschienen in
Pediatric Cardiology / Ausgabe 8/2019
Print ISSN: 0172-0643
Elektronische ISSN: 1432-1971
DOI
https://doi.org/10.1007/s00246-019-02212-1

Weitere Artikel der Ausgabe 8/2019

Pediatric Cardiology 8/2019 Zur Ausgabe

Images in Pediatric Cardiology

Herniated Liver Mimicking Right Atrial Mass

Update Kardiologie

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