H-Index
75
Scimago Lab
powered by Scopus
JCR
Clarivate
Analytics
18%
Acceptance
Rate
call: +1.631.470.9640
Mon-Fri 10 am - 2 pm EST

Logo



eISSN: 1643-3750

Get your full text copy in PDF

Force distribution in wire sternum sutures: the consequences for sternal closure rigidity.

Michał Krejca, Przemysław Szmagała, Janusz Skarysz, Krystyna Bochenek, Rafał Ulczok, Jarosław Bis, Andrzej Bochenek

Med Sci Monit 2003; 9(4): BR134-144

ID: 4703


BACKGROUND: This article provides a biomechanical analysis of the distribution of force in wire sutures used for sternal closure in cardiothoracic surgery. MATERIAL/METHODS: The parameters we measured included displacement in the elastic region, plastic limit, and rupture load on the closure. Force distribution analysis was carried out for every kind of wire suture. A linear regression line of displacement as a function of increasing load was determined for each closure method. RESULTS: Straight wire had less displacement at each load, figure-8 had medium, and interlocking multitwisted (IM) had the most displacement within the elastic range of the specimen. The differences between straight and interlocking multitwisted sutures were statistically significant. When the plastic limit was compared between straight and interlocking multitwisted closure, the differences were statistically significant. In the straight suture the forces used to approximate the sternal halves are perpendicular to the incision. With the figure-8 and interlocking multitwisted suture, the forces are dispersed and the effective approximation force is lower than that applied to the wires. CONCLUSIONS: Straight wires provide good fixation stability for the durability of the sternum, and the somewhat lower strength could be compensated by increasing the number of sutures. The figure-8 and IM have better strength and are less likely to cut the sternum because of advantageous redistribution of shearing forces of the wire as compared to straight closures.

This paper has been published under Creative Common Attribution-NonCommercial-NoDerivatives 4.0 International (CC BY-NC-ND 4.0) allowing to download articles and share them with others as long as they credit the authors and the publisher, but without permission to change them in any way or use them commercially.
I agree