28528
document
Polydioxanone sternal sutures for prevention of sternal dehiscence . BACKGROUND Sternal dehiscence and wound instability are troublesome complications following median sternotomy . Classic sternal approximation with stainless steel wires may not be the ideal approach in patients predisposed to these complications . We tested the efficacy of polydioxanone ( PDS ) suture in sternal closure and in prevention of complications in comparison to steel wires in high-risk individuals . METHODS Three hundred sixty-six patients undergoing elective cardiac surgery with full median sternotomy and having body surface area ( BSA ) less than 1.5 m ( 2 ) were randomly assigned to receive PDS ( n = 181 ) or stainless steel ( SS , n = 185 ) sternal approximation . The study was focused on aseptic sternal complications , namely bone dehiscence and superficial wound instability . RESULTS Both bone dehiscence and superficial wound instability were less frequent in the PDS Group ( 4 and 3 cases in the SS Group , respectively , vs. no cases in the PDS Group ) . Cox proportional hazards regression model in the whole study population identified female sex , chronic renal insufficiency , diabetes , advanced age , lower sternal thickness , osteoporosis , corticosteroid therapy , and prolonged CPB or ventilation times as predisposing factors to any of the two studied sternal complications . DISCUSSION Data suggest that PDS suture can protect against development of aseptic sternal complications following median sternotomy in high-risk patients with little body mass . The adoption of PDS in other subsets of patients , i.e. , obese individuals , is to be questioned .
28529
Intervention_Surgical
Polydioxanone sternal sutures
28530
Intervention_Surgical
polydioxanone ( PDS ) suture
28531
Intervention_Surgical
PDS
28532
Intervention_Surgical
stainless steel
28533
Intervention_Surgical
PDS
28534
Intervention_Surgical
PDS
28535
Intervention_Surgical
PDS
28536
Outcome_Physical
Sternal dehiscence
28537
Outcome_Physical
wound instability
28538
Outcome_Other
efficacy
28539
Outcome_Physical
sternal closure
28540
Outcome_Adverse-effects
complications
28541
Outcome_Physical
bone dehiscence
28542
Outcome_Physical
superficial wound instability
28543
Outcome_Physical
bone dehiscence
28544
Outcome_Physical
superficial wound instability
28545
Outcome_Physical
diabetes
28546
Outcome_Physical
osteoporosis
28547
Outcome_Adverse-effects
aseptic sternal complications