Bone cement-enhanced sternal closure technique in cardiac surgery: effects on sternal union, pain and life quality

• Published in: Journal of cardiothoracic surgery 2013-08, Vol.8 (1), p.182-182, Article 182
• Main Authors: Bayramoglu, Zehra, Durak, Yasemen, Bayram, Muhammed, Ulusoy, Onur Levent, Caynak, Barıs, Sagbas, Ertan, Akpınar, Belhan
• Format: Article
• Language: English
• Subjects: Aged; Aged, 80 and over; Body mass index; Bone Wires; Cardiac patients; Cardiac Surgical Procedures; Cardiology; Care and treatment; Castor Oil - therapeutic use; Chronic obstructive pulmonary disease; Complications and side effects; CT imaging; Female; Follow-Up Studies; Heart; Humans; Male; Mechanical properties; Medical research; Medicine, Experimental; Middle Aged; Mortality; Pain; Pain Measurement; Pain, Postoperative - prevention & control; Polymers - therapeutic use; Quality of Life; Respiratory tract diseases; Sternotomy - methods; Sternum - surgery; Surgery; Surveys and Questionnaires; Treatment Outcome; Wound Closure Techniques; Wound Healing
• ISSN: 1749-8090; 1749-8090
• DOI: 10.1186/1749-8090-8-182

Median sternotomy provides excellent access to all mediastinal structures in patients undergoing conventional cardiovascular surgery. Although this incision technique is associated with relatively lower complication rates, certain complications such as the sternal dehiscence may pose serious health consequences. In this regard, considerable effort has been paid to develop techniques aiming to improve sternal healing and to enhance postoperative recovery after conventional cardiac surgery. Among these, kryptonite bone cement, a biocompatible polymer with improved mechanical properties when combined with a standard wire cerclage, represents a promising novel approach that may help prevent sternal dehiscence. In this study, the effects of this particular type of bone cement on sternal healing, postoperative pain, and quality of life have been evaluated. Kryptonite bone cement enhanced sternal closure was employed in a total of 100 patients undergoing conventional cardiac surgery between November 2009 and June 2012. Of these patients, 50 expressed their willingness to participate in this study. Each participant underwent a computerized tomography imaging for the radiological assessment of sternal healing. Pain and life quality of these patients have been evaluated by Wong-Baker faces pain scale and SF-36 health survey questionnaire, respectively. Mean duration of follow-up was 20.14 ± 7.36 months (range: 10-32). Mean age and body mass index were 71.32 ± 7.23 years (range: 55-85) and 28.34 ± 2.62 (21-34) kg/m2, respectively. Elderly patients (≥70), females and those with chronic obstructive pulmonary disease (COPD) comprised 64%, 26% and 40% of the study population, respectively. No patients had findings suggestive of dehiscence on CT images. No patients reported severe pain (i.e. all patients had a Wong-Baker faces pain scale score