1. 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 (October 2007)
DOI: /j.athoracsur
Copyright © 2007 The Society of Thoracic Surgeons Terms and Conditions

2. 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  , DOI: ( /j.athoracsur )
Copyright © 2007 The Society of Thoracic Surgeons Terms and Conditions

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

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

5. 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  , DOI: ( /j.athoracsur )
Copyright © 2007 The Society of Thoracic Surgeons Terms and Conditions

6. 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  , DOI: ( /j.athoracsur )
Copyright © 2007 The Society of Thoracic Surgeons Terms and Conditions