"/" wiring (Durukan weave) to prevent sternal cutting by wires: a propensity score matched comparison with Robicsek weave.

Abstract

Introduction: Sternal closure still causes morbidity/mortality following sternotomy. Robicsek weave, cable systems, rigid plates and nitinol clips are systems employed to prevent sternal dehiscence.

Aim: The aim was to document the effectiveness of a novel method using standard sternal wires decreasing load on wires and spreading load on the lateral sternum to prevent sternal cutting by wires and thus sternal dehiscence.

Material and methods: 756 patients who underwent coronary revascularization with sternotomy between July 2018 and November 2022 were retrospectively analyzed. Fifty patients with "/"wiring were compared with 50 patients with Robicsek weave by propensity score matching. "/" wiring (Durukan weave) spreads load laterally on the sternum by lateral sequential knotting of wires instead of midline knotting. Outcomes were superficial and deep sternal wound infection and non-infectious sternal dehiscence.

Results: There were 50 patients in each group. Mean age of the patients was 65.74 ±7.47 in Robicsek weave and 66.12 ±7.23 in Durukan weave. The perioperative characteristics of patients were comparable as propensity score matching was performed. None developed superficial sternal wound infection in Robicsek weave, whereas 2% (1) in "/"wiring. There was no deep sternal wound infection in each group. Non-infectious sternal dehiscence did not occur in either group.

Conclusions: "/" wiring seems to be a safe and cost-effective method for sternal closure for preventing sternal cutting by wires, therefore preventing sternal wound related problems and dehiscence. The method is cheap, easily applicable and less time consuming than Robicsek weave, which was proven to be the safest method for sternal wire closure.