The global population is changing. It is aging, leading a less healthy lifestyle and taking full advantage of the technological advances occurring in health care. These factors are contributing to a higher risk level for patients being treated with open cardiac surgery.
The patient’s risk of infection and other complications increases significantly with the presentation of additional risk factors, such as obesity, diabetes and COPD. Postoperative deep sternal wound infection with sternal dehiscence is a severe complication occurring in 1-5% of patients.1,2
DePuy Synthes offers a variety of sternal closure solutions to accommodate the varying needs of the changing global population. Sternal ZipFix, as an easy to use sternal closure system, offers various advantages over conventional wire closure. This solution is our recommendation for patients up to medium risk level.4 For severe obese patients, especially in combination with other risk factors, primary sternal plating should be considered3.
1)Robicsek F, Fokin A, Cook J, Bhatia D. Sternal Instability after Midline Sternotomy. Thorac Cardiov Surg
2000; 48: 1-8
2)Molina JE, Lew RS, Hyland KJ. Postoperative sternal dehiscence in obese patients: incidence and prevention. Ann Thorac Surg. 2004 Sep;78(3):912-7; discussion 912-7. PubMed PMID: 15337019.
3)J. Raman et al: Sternal closure with titanium plate fixation – a paradigm shift in preventing mediastinitis
4)Grapow et al. Journal of Cardiothoracic Surgery 2012, 7:59