Practice Patterns in Sternal Closure and Evaluation of Adoption of a Novel Sternal Closure Device.

IF 1.6 Q2 SURGERY
Gardner Yost, Thomas Marten, Jeffrey Plott, Jonathan W Haft
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引用次数: 0

Abstract

Objective: The technique for sternal closure has remained largely unchanged owing to the efficacy, simplicity, and low cost of stainless-steel sternal wires. Despite their ubiquity, several other closure devices designed to address the complications associated with sternal wires such as sternal bleeding and dehiscence have become popular. We have developed a novel sternal closure device that reduces sternal bleeding and dehiscence. This study quantifies the use of currently available sternal closure devices and determines predicted uptake of the novel device.

Methods: An electronic survey, designed to determine practice patterns for sternal closure, was distributed to 70 US cardiac surgeons. The survey included a discrete choice section in which surgeons evaluated relative value of device attributes including cost, ease of emergent sternal reentry, and dehiscence risk.

Results: There were 70 surgeons from 30 states who completed the survey. The most frequent means of sternal closure was straight sternal wires (35.8%), followed by straight sternal wires plus figure-of-8 sternal wires (18.1%), double wires (10.9%), plates (10.2%), and other (25%). The relative utilization shifted from sternal wires to sternal plates as the risk for dehiscence increased. The adoption of the novel closure device was estimated at 34.6%.

Conclusions: The standard stainless-steel sternal wire remains the most common means of sternal reapproximation, but its utilization is lower in patients at high risk for sternal dehiscence. Based on this survey, there is acceptance in the community for a novel sternal closure device designed to address the limitations of traditional sternal closure methods.

胸骨闭合术的实践模式以及对采用新型胸骨闭合设备的评估。
目的:由于不锈钢胸骨线的功效、简便性和低成本,胸骨闭合技术在很大程度上保持不变。尽管不锈钢胸骨线无处不在,但其他几种旨在解决胸骨线相关并发症(如胸骨出血和开裂)的闭合装置也开始流行起来。我们开发了一种新型胸骨闭合装置,可减少胸骨出血和开裂。本研究量化了目前可用的胸骨闭合装置的使用情况,并确定了新型装置的预测使用率:向 70 名美国心脏外科医生发放了一份电子调查表,旨在确定胸骨闭合的实践模式。调查包括一个离散选择部分,由外科医生评估装置属性的相对价值,包括成本、紧急胸骨复位的难易程度和开裂风险:来自 30 个州的 70 名外科医生完成了调查。最常用的胸骨闭合方法是直胸骨线(35.8%),其次是直胸骨线加8字形胸骨线(18.1%)、双线(10.9%)、钢板(10.2%)和其他(25%)。随着开裂风险的增加,相对使用率从胸骨线转向胸骨板。新型闭合装置的采用率估计为34.6%:结论:标准不锈钢胸骨线仍是最常用的胸骨复位方法,但在胸骨开裂高风险患者中使用率较低。根据这项调查,社区接受了一种新型胸骨闭合装置,该装置旨在解决传统胸骨闭合方法的局限性。
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来源期刊
CiteScore
2.00
自引率
6.70%
发文量
80
期刊介绍: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery is the first journal whose main mission is to disseminate information specifically about advances in technology and techniques that lead to less invasive treatment of cardiothoracic and vascular disease. It delivers cutting edge original research, reviews, essays, case reports, and editorials from the pioneers and experts in the field of minimally invasive cardiothoracic and vascular disease, including biomedical engineers. Also included are papers presented at the annual ISMICS meeting. Official Journal of the International Society for Minimally Invasive Cardiothoracic Surgery
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