Impaired sternal wound healing remains problematic after median sternotomy and can lead to significant morbidity after cardiac surgical procedures. Although metal plating systems exist for closing the sternum, their use is limited by expense and practicality, and simple wire closure remains the most common technique to close the sternum. We describe a cabling technique for sternal closure that is secure, uses standard sternal wire, and may be used on every patient. We have used the technique routinely in 291 patients with no sternal dehiscence or wound healing problems.
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http://dx.doi.org/10.1016/j.athoracsur.2012.05.067 | DOI Listing |
Indian J Thorac Cardiovasc Surg
February 2025
Department of Paediatric and Congenital Heart Surgery, Kokilaben Dhirubhai Ambani Hospital and Medical Research Institute, Rao Saheb, Achutrao Patwardhan Marg, Four Bungalows, Andheri West, Mumbai, Maharashtra 400053 India.
Unlabelled: In congenital heart surgery, redo-sternotomies are very common. In most cases, sternal re-entry is achieved without serious complications. However, sometimes elective institution of peripheral cardiopulmonary bypass is needed for safe sternotomy, albeit with a long cardio-pulmonary bypass time.
View Article and Find Full Text PDFPlast Reconstr Surg Glob Open
January 2025
From the Department of Plastic and Reconstructive Surgery, Rabin Medical Center, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
Background: Over the past 2 decades, vertical scar reduction mammaplasty techniques have been gaining more acceptance. However, many surgeons are still hesitant to use it routinely because of the uncertainty of the effectiveness of vertical scar techniques in managing lower pole skin excess. We aimed to test its efficacy by using objective anthropometric measurements to evaluate long-term breast shape and lower pole stability.
View Article and Find Full Text PDFBackground: The Sarasota Memorial Health Care System (SMHCS) Acute Care Rehabilitation Team began implementing the Keep Your Move in the Tube (KYMITT) protocol in February 2023 to improve patient mobility and offer an alternative to traditional sternal precautions. The goal of KYMITT is for patients to remain within a safe zone (referred to as "the tube") rather than complying with time and weight restrictions, which are the cornerstone of traditional sternal precautions. In previous studies, KYMITT was associated with greater independence after surgery without placing patients at an increased risk of experiencing a surgical site infection.
View Article and Find Full Text PDFMultimed Man Cardiothorac Surg
January 2025
Hibino Laboratory, University of Chicago Medicine, Chicago, IL, USA.
With the increase of patients with adult congenital heart disease, the number of high-risk multiple redo sternotomies is increasing. Calcified conduit embedded in the sternum or large vessels attached to the sternum presents an especially challenging case. This video tutorial presents a simple safe redo sternotomy technique using an ultrasonic bone scalpel in such high-risk patients.
View Article and Find Full Text PDFInt J Surg
December 2024
Department of Plastic and Reconstructive Surgery, Chang Gung Memorial Hospital, Taoyuan, Taiwan and College of Medical, Chang Gung University, Taoyuan, Taiwan.
Background: Deep sternal wound infection (DSWI) is a severe and life-threatening complication following cardiovascular surgery. Negative pressure wound therapy (NPWT) has emerged as a promising therapeutic bridging option for DSWI. In this systematic review and meta-analysis, the authors aimed to evaluate the impact of NPWT on clinical outcomes in patients with DSWI.
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