초록접수 현황
| 14F-211 | 포럼 발표 |
Sternal Fixation with Titanium Plates as an Altenative to Conventional Steel Wires after Cardiac Surgery
정병권, 유재석, 김준범, 정성호, 주석중, 정철현, 이재원
울산대학교 의과대학 서울아산병원 흉부외과학교실
Background : Steel wires have been usually used for sternal closure after cardiac surgery. In particular patients with high risks of sternal wound problem, however, other alternative materials are often required. Although sternal fixation using rigid titanium plates has been introduced, it has not been widely adopted for cardiac surgeons. The current study aimed to evaluate the efficacy of titanium plate for sternal closure.
Methods : A total of 379 patients who underwent titanium plate fixation after cardiac surgery between May 2012 and June 2014 were retrospectively reviewed. Demographic factors, indications for surgery, and risk factors for postoperative complications including mediastinitis and sternal nonunion were reviewed. The types of fixation system was recorded. We assessed the operative and clinical outcomes including wound dehiscence, superficial and deep sternal wound infection, sternal instability and requirement for wound revision.
Results : A total of 442 titanium plates (StenaLock®, Biomet Inc.) were utilized in the 379 cardiac surgeries (including 48 heart transplantations and 19 sternal reconstruction for mediastinitis). The types of titanium plates used are shown in Figure. There were no intraoperative problem in utilizing the titanium plates for sternal closure. At a median of 13.4 months (interquartile range: 7.2 – 19.7 months) of follow-up, postoperative wound problems occurred in only 2 patients (0.5%), in whom the titanium plates had been used for sternal reconstruction due to mediastinitis. The wound problem rate was low compared to that of the patients who underwent conventional wire cerclage for sternal closure at our institution in the same period: 3.2% (77 of 2,422 patients).
Conclusion : Rigid sternal fixation using titanium plates in some particular patient group with high risks of sternal wound problem after cardiac surgery can be used as an effective alternative to conventional steel wires.
Methods : A total of 379 patients who underwent titanium plate fixation after cardiac surgery between May 2012 and June 2014 were retrospectively reviewed. Demographic factors, indications for surgery, and risk factors for postoperative complications including mediastinitis and sternal nonunion were reviewed. The types of fixation system was recorded. We assessed the operative and clinical outcomes including wound dehiscence, superficial and deep sternal wound infection, sternal instability and requirement for wound revision.
Results : A total of 442 titanium plates (StenaLock®, Biomet Inc.) were utilized in the 379 cardiac surgeries (including 48 heart transplantations and 19 sternal reconstruction for mediastinitis). The types of titanium plates used are shown in Figure. There were no intraoperative problem in utilizing the titanium plates for sternal closure. At a median of 13.4 months (interquartile range: 7.2 – 19.7 months) of follow-up, postoperative wound problems occurred in only 2 patients (0.5%), in whom the titanium plates had been used for sternal reconstruction due to mediastinitis. The wound problem rate was low compared to that of the patients who underwent conventional wire cerclage for sternal closure at our institution in the same period: 3.2% (77 of 2,422 patients).
Conclusion : Rigid sternal fixation using titanium plates in some particular patient group with high risks of sternal wound problem after cardiac surgery can be used as an effective alternative to conventional steel wires.
책임저자: 이재원
울산대학교 의과대학 서울아산병원 흉부외과학교실
연락처 : 정병권, Tel: 02-3010-3580 , E-mail : pogri@naver.com
