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Post-Surgical Outcomes After Sternal Closure Using Zipfix Band and Steel Wires

Received: 30 November 2020    Accepted: 19 December 2020    Published: 25 December 2020
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Abstract

Median sternotomy is the most commonly used and the standard way of an incision after cardiothoracic procedures. The use of stainless steel wire has been considered the gold standard in the sternal closure system; however, increasing postoperative complications have caused other options. The aim of this study is to understand the combined effect of the ZipFix bands with steel wires on postoperative outcomes after sternal closure. This is a real-world evidence study of patients treated using the ZipFix band and steel wires. The sternal closure is performed by fixing of manubrium with straight simple wires, followed with ZipFix 3 or 4 spaces. Demographic characters of patients using the ZipFix band and steel wire and their relation to sternal infections, wound dehiscence, and post-surgical outcomes are studied. From gathered evidence, 2% of patients’ cases were complicated with the incidence of sternal infections. Ninety-nine percentage of patients had a stable and healthy wound while 1% of patients showed sternal wound dehiscence. The mean duration of hospital and intensive care unit stay was 8.53 (± 4.84) days and 3.58 (± 5.01) days respectively. The use of the sternal ZipFix system in combination with stainless steel wire is found to be effective in reducing post-surgical complications.

Published in International Journal of Cardiovascular and Thoracic Surgery (Volume 6, Issue 6)
DOI 10.11648/j.ijcts.20200606.15
Page(s) 85-89
Creative Commons

This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.

Copyright

Copyright © The Author(s), 2024. Published by Science Publishing Group

Keywords

Zipfix, Median Sternotomy, Stainless Steel Wires, Sternal Wound Infections

References
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[2] Kubota H, Miyata H, Motomura N, Ono M, Takamoto S, Harii K, et al. Deep sternal wound infection after cardiac surgery. J Cardiothorac Surg. 2013; 8: 132.
[3] Tang A. Novel application of vacuum assisted closure technique to the treatment of sternotomy wound infection. European Journal of Cardio-Thoracic Surgery. 2000; 17: 482–4.
[4] Gårdlund B. Postoperative mediastinitis in cardiac surgery — microbiology and pathogenesis. European Journal of Cardio-Thoracic Surgery. 2002; 21: 825–30.
[5] Lu J. Risk factors for sternal wound infection and mid-term survival following coronary artery bypass surgery. European Journal of Cardio-Thoracic Surgery [Internet]. 2003; 23: 943–9.
[6] Nezafati P, Shomali A, Kahrom M, Omidvar Tehrani S, Dianatkhah M, Nezafati MH. ZipFix Versus Conventional Sternal Closure: One-Year Follow-Up. Heart, Lung and Circulation. 2019; 28: 443–9.
[7] Melly L, Gahl B, Meinke R, Rueter F, Matt P, Reuthebuch O, et al. A new cable-tie-based sternal closure device: infectious considerations†. Interactive CardioVascular and Thoracic Surgery. 2013; 17: 219–24.
[8] Stelly MM, Rodning CB, Stelly TC. Reduction in deep sternal wound infection with use of a peristernal cable-tie closure system: a retrospective case series. J Cardiothorac Surg. 2015; 10: 166.
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[11] Raman J, Lehmann S, Zehr K, De Guzman BJ, Aklog L, Garrett HE, et al. Sternal Closure With Rigid Plate Fixation Versus Wire Closure: A Randomized Controlled Multicenter Trial. The Annals of Thoracic Surgery. 2012; 94: 1854–61.
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[13] Schimmer C, Reents W, Berneder S, Eigel P, Sezer O, Scheld H, et al. Prevention of Sternal Dehiscence and Infection in High-Risk Patients: A Prospective Randomized Multicenter Trial. The Annals of Thoracic Surgery. 2008; 86: 1897–904.
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[16] Bhattacharya S, Sau I, Mohan M, Hazari K, Basu R, Kaul A. Sternal Bands for Closure of Midline Sternotomy Leads to Better Wound Healing. Asian Cardiovasc Thorac Ann. 2007; 15: 59–63.
[17] Milano CA, Kesler K, Archibald N, Sexton DJ, Jones RH. Mediastinitis After Coronary Artery Bypass Graft Surgery: Risk Factors and Long-term Survival. Circulation. 1995; 92: 2245–51.
[18] Matros E, Aranki SF, Bayer LR, McGurk S, Neuwalder J, Orgill DP. Reduction in incidence of deep sternal wound infections: Random or real? The Journal of Thoracic and Cardiovascular Surgery. 2010; 139: 680–5.
[19] Oh YN, Ha KJ, Kim JB, Jung S-H, Choo SJ, Chung CH, et al. Multifilament Cable Wire versus Conventional Wire for Sternal Closure in Patients Undergoing Major Cardiac Surgery. Korean J Thorac Cardiovasc Surg. 2015; 48: 265–71.
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Cite This Article
  • APA Style

    Udgeath Dhir, Anand Kumar, Rakesh Saklani, Vishal Jain. (2020). Post-Surgical Outcomes After Sternal Closure Using Zipfix Band and Steel Wires. International Journal of Cardiovascular and Thoracic Surgery, 6(6), 85-89. https://doi.org/10.11648/j.ijcts.20200606.15

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    ACS Style

    Udgeath Dhir; Anand Kumar; Rakesh Saklani; Vishal Jain. Post-Surgical Outcomes After Sternal Closure Using Zipfix Band and Steel Wires. Int. J. Cardiovasc. Thorac. Surg. 2020, 6(6), 85-89. doi: 10.11648/j.ijcts.20200606.15

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    AMA Style

    Udgeath Dhir, Anand Kumar, Rakesh Saklani, Vishal Jain. Post-Surgical Outcomes After Sternal Closure Using Zipfix Band and Steel Wires. Int J Cardiovasc Thorac Surg. 2020;6(6):85-89. doi: 10.11648/j.ijcts.20200606.15

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  • @article{10.11648/j.ijcts.20200606.15,
      author = {Udgeath Dhir and Anand Kumar and Rakesh Saklani and Vishal Jain},
      title = {Post-Surgical Outcomes After Sternal Closure Using Zipfix Band and Steel Wires},
      journal = {International Journal of Cardiovascular and Thoracic Surgery},
      volume = {6},
      number = {6},
      pages = {85-89},
      doi = {10.11648/j.ijcts.20200606.15},
      url = {https://doi.org/10.11648/j.ijcts.20200606.15},
      eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ijcts.20200606.15},
      abstract = {Median sternotomy is the most commonly used and the standard way of an incision after cardiothoracic procedures. The use of stainless steel wire has been considered the gold standard in the sternal closure system; however, increasing postoperative complications have caused other options. The aim of this study is to understand the combined effect of the ZipFix bands with steel wires on postoperative outcomes after sternal closure. This is a real-world evidence study of patients treated using the ZipFix band and steel wires. The sternal closure is performed by fixing of manubrium with straight simple wires, followed with ZipFix 3 or 4 spaces. Demographic characters of patients using the ZipFix band and steel wire and their relation to sternal infections, wound dehiscence, and post-surgical outcomes are studied. From gathered evidence, 2% of patients’ cases were complicated with the incidence of sternal infections. Ninety-nine percentage of patients had a stable and healthy wound while 1% of patients showed sternal wound dehiscence. The mean duration of hospital and intensive care unit stay was 8.53 (± 4.84) days and 3.58 (± 5.01) days respectively. The use of the sternal ZipFix system in combination with stainless steel wire is found to be effective in reducing post-surgical complications.},
     year = {2020}
    }
    

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  • TY  - JOUR
    T1  - Post-Surgical Outcomes After Sternal Closure Using Zipfix Band and Steel Wires
    AU  - Udgeath Dhir
    AU  - Anand Kumar
    AU  - Rakesh Saklani
    AU  - Vishal Jain
    Y1  - 2020/12/25
    PY  - 2020
    N1  - https://doi.org/10.11648/j.ijcts.20200606.15
    DO  - 10.11648/j.ijcts.20200606.15
    T2  - International Journal of Cardiovascular and Thoracic Surgery
    JF  - International Journal of Cardiovascular and Thoracic Surgery
    JO  - International Journal of Cardiovascular and Thoracic Surgery
    SP  - 85
    EP  - 89
    PB  - Science Publishing Group
    SN  - 2575-4882
    UR  - https://doi.org/10.11648/j.ijcts.20200606.15
    AB  - Median sternotomy is the most commonly used and the standard way of an incision after cardiothoracic procedures. The use of stainless steel wire has been considered the gold standard in the sternal closure system; however, increasing postoperative complications have caused other options. The aim of this study is to understand the combined effect of the ZipFix bands with steel wires on postoperative outcomes after sternal closure. This is a real-world evidence study of patients treated using the ZipFix band and steel wires. The sternal closure is performed by fixing of manubrium with straight simple wires, followed with ZipFix 3 or 4 spaces. Demographic characters of patients using the ZipFix band and steel wire and their relation to sternal infections, wound dehiscence, and post-surgical outcomes are studied. From gathered evidence, 2% of patients’ cases were complicated with the incidence of sternal infections. Ninety-nine percentage of patients had a stable and healthy wound while 1% of patients showed sternal wound dehiscence. The mean duration of hospital and intensive care unit stay was 8.53 (± 4.84) days and 3.58 (± 5.01) days respectively. The use of the sternal ZipFix system in combination with stainless steel wire is found to be effective in reducing post-surgical complications.
    VL  - 6
    IS  - 6
    ER  - 

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Author Information
  • Department of Cardiothoracic and Vascular Surgery, Fortis Memorial Research Institute, Gurgaon, India

  • Department of Cardiothoracic and Vascular Surgery, Fortis Memorial Research Institute, Gurgaon, India

  • Department of Cardiothoracic and Vascular Surgery, Fortis Memorial Research Institute, Gurgaon, India

  • Department of Cardiac Anaesthesia, Fortis Memorial Research Institute, Gurgaon, India

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