There is currently no consensus on the treatment of median sternotomy patients presenting secondarily with deep sternal wound infection or symptomatic sternal nonunion. We have developed a novel approach to sternal bone fixation when concerns for open wounds or microbial colonization preclude the use of permanent hardware placement: (1) sternal closure with absorbable interosseous monocortical horizontal mattress sutures followed by (2) multilayered soft tissue closure with pectoralis major advancement or turnover flaps. Benefits of this technique include: closure of retrosternal dead-space, tension offloading of the soft tissue closure, repair of transverse sternal fractures, and preservation of internal mammary artery (IMA) perforators for potential pectoralis turnover flaps. In our early experience, this technique has been successful at promoting functional sternal union - even in secondary closure of high-risk patients contraindicated for permanent hardware placement.
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http://dx.doi.org/10.1016/j.bjps.2023.10.103 | DOI Listing |
Arthrosc Tech
November 2024
Department of Sports Medicine, Peking University Third Hospital, Institute of Sports Medicine of Peking University, Beijing, China.
Rotator cuff tear is a common type of injury. For the treatment of rotator cuff tears, arthroscopic surgery is widely used. However, for massive rotator cuff tears, the rate of recurrent tears after arthroscopic surgical repair is higher.
View Article and Find Full Text PDFAorta (Stamford)
December 2024
Division of Cardiovascular Surgery, Department of Surgery, University of Florida Health, Gainesville, Florida.
A 71-year-old gentleman with prior bioprosthetic aortic valve replacement was admitted with aortic valve dehiscence and an aortic root abscess. He underwent reoperative sternotomy, aortic root, mitral valve, and hemiarch replacement. To augment hemostasis, we implanted the "Martin Mattress"-a pericardial patch sutured to the fibrous ridge within the innominate vein, superior vena cava, right atrium, right ventricular outflow tract, and pulmonary artery-which is preferred to modified Cabrol fistula techniques in infectious root pathology.
View Article and Find Full Text PDFSurg Technol Int
December 2024
Department of Gastroenterological Surgery, Clinique Clementville, Montpellier, France.
Introduction: Preventing staple line bleeding (SLB) is still a main issue in bariatric surgery procedures, especially after laparoscopic sleeve gastrectomy (LSG). Staple line reinforcements (SLR), mattress sutures, or titanium clip application did not show any statistical superiority compared to other methods. In this randomized controlled trial, we tested hemostatic powder (HP) in order to assess a possible role in the prevention of active bleeding, hematoma formation, the need for transfusions, and the increased risk for hospitalization.
View Article and Find Full Text PDFAsia Pac J Sports Med Arthrosc Rehabil Technol
January 2025
Sports Medicine Institute of Fudan University, Department of Sports Medicine, Huashan Hospital, Fudan University, Shanghai, 200040, PR China.
Purpose: To use a finite element method to construct a patch-bridge repair model for massive rotator cuff tears (MRCTs) and investigate the effects of different suture methods and knot numbers on postoperative biomechanics.
Methods: A finite element model based on intact glenohumeral joint data was used for a biomechanical study. A full-thickness defect and retraction model of the supraspinatus tendon simulated MRCTs.
Aesthetic Plast Surg
December 2024
Department of Plastic and Reconstructive Surgery, Institute of Plastic Surgery and Cosmetology, Ol'khovskaya Ulitsa, 27, Moscow, Russia.
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