Novel use of interosseous absorbable mattress sutures for secondary sternal fixation: A case series

There is currently no consensus on the treatment of median sternotomy patients presenting secondarily with deep sternal wound infection or symptomatic sternal nonunion. We have developed a novel approach to sternal bone fixation when concerns for open wounds or microbial colonization preclude the us...

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Bibliographic Details
Published in:Journal of plastic, reconstructive & aesthetic surgery reconstructive & aesthetic surgery, 2023-12, Vol.87, p.387-389
Main Authors: Chen, Amy, Garvey, Shannon R., Adebagbo, Oluwasean, Park, John, Rahmani, Benjamin, Chu, Louis, Cauley, Ryan P.
Format: Article
Language:English
Subjects:
dehiscence
Fractures, Bone - surgery
horizontal mattress
Humans
interosseous sutures
sternotomy
Sternotomy - adverse effects
Sternum - surgery
Surgical Wound Dehiscence - etiology
Surgical Wound Infection - etiology
Suture Techniques
Treatment Outcome
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Summary:There is currently no consensus on the treatment of median sternotomy patients presenting secondarily with deep sternal wound infection or symptomatic sternal nonunion. We have developed a novel approach to sternal bone fixation when concerns for open wounds or microbial colonization preclude the use of permanent hardware placement: (1) sternal closure with absorbable interosseous monocortical horizontal mattress sutures followed by (2) multilayered soft tissue closure with pectoralis major advancement or turnover flaps. Benefits of this technique include: closure of retrosternal dead-space, tension offloading of the soft tissue closure, repair of transverse sternal fractures, and preservation of internal mammary artery (IMA) perforators for potential pectoralis turnover flaps. In our early experience, this technique has been successful at promoting functional sternal union - even in secondary closure of high-risk patients contraindicated for permanent hardware placement.
ISSN:1748-6815
1878-0539
DOI:10.1016/j.bjps.2023.10.103