Sternal fixation using new synthetic cable ties implants (Zip-Fix® System)
| Autor: | Johannes Rösch, T Zielezinski, M. Weyand, T Seitz, F. Harig |
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| Rok vydání: | 2012 |
| Předmět: | |
| Zdroj: | The Thoracic and Cardiovascular Surgeon. 60 |
| ISSN: | 1439-1902 0171-6425 |
| Popis: | Objectives: Sternal dehiscence is a severe complication in cardiac surgical procedures using mid sternotomy as the standard access. Alternative techniques to traditional wiring may reduce the incidence of sternal dehiscence. Methods: In this initial observational study, we present an alternative technique for sternal osteosynthesis, the use of synthetic bands, like cable-ties, made of biocompatible polyether-etherketon (PEEK) to be implanted peristernally. These implants have a larger implant to bone contact area and show a 5 times higher degree of resilience. Results: We performed primary sternal fixation using ZipFix in 31 pts. (from 5/2011 to 9/2011) after mid sternotomy for standard cardiac surgical procedures (CABG: 85%; AVR: 11%; others (HTX): 4%). In this cohort, mean age was 68y (40% over 75y old), 37% had diabetes mellitus, COPD occurred in 30%. The mean body weight was 92.6kg±15.6kg, (range 64–134); mean Obesity (BMI>25) was present in 87%, malignant obesity (BMI >40) in 13%; heavy- weighted patients, i.e. more than 100kg, were present in 35% of patients. Secondary wound dehiscence occurred in two patients (122kg and 134kg) of 28 (7%), due to marginal transsection of the sternum. Conclusions: The cable ties technique using ZipFix is an appropriate device to reduce the incidence of sternal dehiscence after mid sternotomy in patients at high risk for sternal dehiscence. Parasternal implantation technique is recommended. Additional use of wires in the manubrium sterni is optional. As the incidence of obesity is steadily increasing, a more frequent use is expected in the future. |
| Databáze: | OpenAIRE |
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