Evaluation of sternum closure methods (with clinical results) in open heart surgery

Introduction: In our study, we investigated the clinical results of sternum closure methods after open heart surgery with median sternotomy. Materials and Methods: 2662 patients who had undergone open heart surgery were retrospectively screened. Classical steel wire, flexigrip+steel wire combination, sternal cable, sternal band, and robicsek were used as sternum closure methods in patients. The causality relationships of sternal dehiscence, diabetes mellitus, chronic obstructive pulmonary disease, impaired kidney function and demographic characteristics of the patients were investigated. Results: The risk of sternal dehiscence is high in patients with risk factors such as chronic obstructive pulmonary disease, diabetes mellitus, and impaired renal function who have undergone open heart surgery. Of the 96 patients who developed dehiscence, 60% had DM, 25% had IRF, and 21% had COPD. The treatment success rate was found to be 88% when using the flexigrip + wire combination in patients undergoing sternal dehiscence repair, and the treatment success rate was 76% in patients using classical steel wire. In our study, it was observed that the combination of flexigrip + steel wire significantly reduced the risk of sternal dehiscence compared to the use of classical steel wire in sternal closure. Conclusion: It has been observed that the use of flexigrip + steel wire combination in sternal closure significantly reduces the risk of sternal dehiscence in patients with diabetes mellitus, chronic obstructive pulmonary disease, impaired kidney function.