Fatigue testing of three peristernal median sternotomy closure techniques
2008

Testing Closure Techniques for Sternotomy

Sample size: 15 publication Evidence: high

Author Information

Author(s): Cameron Wangsgard, David J Cohen, Lanny V Griffin

Primary Institution: California Polytechnic State University

Hypothesis

A sternotomy closure system that uses either stainless-steel cables or stainless-steel plates to distribute local stresses of the wires on the sternum will be less prone to fatigue-based failure in-vivo when compared to stainless steel wires.

Conclusion

The study found that stainless-steel cables and plates are significantly more reliable than wires for sternotomy closure.

Supporting Evidence

  • The figure-of-eight stainless-steel cable system is the most resistant to failure.
  • All figure-of-eight stainless-steel wire closures failed during testing.
  • The DSF plate system had a high probability of survival up to 100,000 cycles.

Takeaway

This study tested different ways to close the chest after heart surgery and found that some methods are much better at not breaking than others.

Methodology

The study tested three closure techniques on polyurethane foam models under cyclic loading until failure or run-out.

Potential Biases

The use of foam models may not perfectly replicate human sternum behavior.

Limitations

The study was conducted in air without the effects of bodily fluids, which may affect fatigue life.

Statistical Information

Statistical Significance

p<0.05

Digital Object Identifier (DOI)

10.1186/1749-8090-3-52

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