Single Wire Versus Double Wire Loops for Median Sternotomy Closure: Experimental Biomechanical Study Using a Human Cadaveric Model Julian E. Losanoff,

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Presentation transcript:

Single Wire Versus Double Wire Loops for Median Sternotomy Closure: Experimental Biomechanical Study Using a Human Cadaveric Model Julian E. Losanoff, MD, Marc D. Basson, MD, PhD, Scott A. Gruber, MD, PhD, Harold Huff, MS, Fu-hung Hsieh, PhD The Annals of Thoracic Surgery Volume 84, Issue 4, Pages 1288-1293 (October 2007) DOI: 10.1016/j.athoracsur.2007.05.023 Copyright © 2007 The Society of Thoracic Surgeons Terms and Conditions

Fig 1 Schematic drawing illustrating the two wiring methods. (Left) single peristernal with four single wire loops; (right) double peristernal with three double loops (arrows). Note a fourth, single wire loop at the bottom of the closure. Each manubrium is closed with three single wires. The Annals of Thoracic Surgery 2007 84, 1288-1293DOI: (10.1016/j.athoracsur.2007.05.023) Copyright © 2007 The Society of Thoracic Surgeons Terms and Conditions

Fig 2 DoubleWire (A&E Medical Corp, Farmingdale, NJ). Inset shows the welded junction of the loop. The Annals of Thoracic Surgery 2007 84, 1288-1293DOI: (10.1016/j.athoracsur.2007.05.023) Copyright © 2007 The Society of Thoracic Surgeons Terms and Conditions

Fig 3 The eccentric hook used to twist the DoubleWire (A&E Medical Corp, Farmingdale, NJ). The Annals of Thoracic Surgery 2007 84, 1288-1293DOI: (10.1016/j.athoracsur.2007.05.023) Copyright © 2007 The Society of Thoracic Surgeons Terms and Conditions

Fig 4 Experimental setup showing a sternal specimen in place during a test. Note that the sternotomy is oriented horizontally and parallel to the clamps. The Annals of Thoracic Surgery 2007 84, 1288-1293DOI: (10.1016/j.athoracsur.2007.05.023) Copyright © 2007 The Society of Thoracic Surgeons Terms and Conditions

Fig 5 A dynamic observation at the beginning (A) and during a maximal pull showing a gap at the closure’s xiphoid end (B). The Annals of Thoracic Surgery 2007 84, 1288-1293DOI: (10.1016/j.athoracsur.2007.05.023) Copyright © 2007 The Society of Thoracic Surgeons Terms and Conditions