Feasibility of the use of absorbable sutures for closure of the sternum in adult cardiac surgery
Iida, H.; Sunazawa, T.; Doi, A.
Kyobu Geka. Japanese Journal of Thoracic Surgery 66(13): 1145-1148
2013
ISSN/ISBN: 0021-5252 PMID: 24322354 Document Number: 665611
Steel wires are commonly used to close median sternotomy during adult cardiac surgery. Disruption or infection of the sternum can occure in 0.3~8% of those patients. We report the use of absorbable sutures for the closure of sternotomy. Three figure of 8 ligations were made. Cranial side suture was placed through the sternal manubrium. Other sutures were placed through the intercostal spaces.Sutures were tied 6 or 7 times. Braided #2 polyglactin suture were used in a consecutive 150 patients. Looped (double) #1 monofilament polyglyconate sutures were used in a subsequent 150 patients. Both sutures with blunt needle are commercially available. None of the patients in either group required re-exploration of the sternum for bleeding and tamponade, and none developed wound infections or mediastinitis. Five patients in the polyglactin group developed seroma and/or instability of the sternum after more than 2 postoperative weeks, but none required surgical refixation of the sternum. These 5 patients had diabetes, chronic renal failure, autoimmune disease and/or chronic lung diseases. None of the patients in the polyglyconate group developed any trouble in their sternum. We conclude that polyglyconate sutures demonstrate good potential for use in closure of the sternum.