Thermoactive Nitinol Clips as Primary and Secondary Sternal Closure after Cardiac Surgery – First Experience in Slovenia
| Autor: | Antonič, Miha, Petrovič, Rene, Gorišek Miksić, Nina |
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| Jazyk: | angličtina |
| Rok vydání: | 2021 |
| Předmět: | |
| Zdroj: | Acta clinica Croatica Volume 60. Issue 3. |
| ISSN: | 1333-9451 0353-9466 |
| Popis: | Although there has been a trend towards minimally invasive and sternum-sparing procedures, median sternotomy is still a standard surgical approach in cardiac surgery. Many techniques and innovations for closure of sternal osteotomy have been developed with contradictory results. In this report, we present our first experience with the nitinol-made sternal closure system in the primary, as well as secondary closure of sternal osteotomy. A small series of 20 patients had their sternotomy closed with Flexigrip clips. In one case, the Flexigrip clips were used in secondary wound closure in a patient with deep sternal wound infection after full sternotomy and coronary bypass surgery. After 6-month follow-up, all patients were doing well with their sternums clinically stable and the sternotomy wounds completely healed. In conclusion, Flexigrip clips offered a stable alternative to steel wires in primary, as well as secondary sternal closure. Moreover, in secondary sternal closure, the thermoactive clips offered safety advantages over the standard wire cerclage technique because the need for dissection of the substernal adhesions could be avoided. Iako postoji trend primjene minimalno invazivnih procedura s očuvanjem sternuma, medijana sternotomija je još uvijek standardni kirurški pristup u kardiokirurgiji. Mnogo je tehnika i inovacija za zatvaranje sternalne osteotomije dosad razvijeno s proturječnim rezultatima. U ovom izvješću iznosimo naše prvo iskustvo sa sustavom sternalnog zatvaranja napravljenog od nitinola u primarnom kao i u sekundarnom zatvaranju sternalne osteotomije. Maloj seriji od 20 kardiokirurških bolesnika sternotomija je bila zatvorena kopčama Flexigrip. Kod jednog bolesnika kopče Flexigrip korištene su za sekundarno zatvaranje rane u slučaju duboke infekcije sternalne rane nakon pune sternotomije i operacije koronarnog premoštenja. Nakon 6-mjesečnog praćenja svi bolesnici bili su dobro, njihovi sternumi su bili klinički stabilni, a rane od sternotomije bile su zacijeljene. Kopče Flexigrip su nudile stabilnu alternativu čeličnim žicama u primarnom kao i u sekundarnom zatvaranju sternuma. Povrh toga, kod sekundarnog zatvaranja sternuma termoaktivne kopče imale su sigurnosne prednosti u odnosu na standardnu tehniku serklaže žicom, jer se mogla izbjeći potreba za disekciju supsternalnih adhezija. |
| Databáze: | OpenAIRE |
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