Sternal wire removal in pediatric patients: wire versus cable sternotomy closure.

摘要

Secure sternal closure after median stemotomy is important to facilitate sternal healing, optimize ventilatory mechanics, and minimize discomfort in the early postoperative period. Many techniques have been reported for sternal closure in adults, with the most widely used involving permanent stainless steel wires or cables. In the pediatric population, absorb-able sutures may be used in smaller patients, but stainless steel wire or cable closure is generally preferred for larger children and teens. Although uncommon, persistent chest wall pain related to sternal wire closure is well described in the adult population and may necessitate reoperation for wire removal. This finding has not been described after cable closure in adults. Furthermore, the frequency of persistent pain after sternal closure with either wire or cable systems in children is unknown. Beginning in March 2005, a cable system was used for sternal closure in all patients larger than 30 kg at our institution. A seemingly disproportionate rate of reoperation for cable removal was subsequently observed. We therefore reviewed our institutional experience with wire and cable sternal closures to compare the performances of these sternal closure systems in the pediatric population.