Reabsorbable Pins can Reinforce an Early Sternal Stability After Median Sternotomy in Young Children with Congenital Heart Disease

• Published in: Pediatric cardiology Vol. 40; no. 8; pp. 1728 - 1734
• Main Authors: Fan, Chengming, Tang, Mi, Wu, Sijie, Yuan, Shuwen, Borovjagin, Anton V., Yang, Jinfu
• Format: Journal Article
• Language: English
• Published: New York Springer US 01-12-2019; Springer
• Subjects: Bone Nails; Cardiac Surgery; Cardiology; Case-Control Studies; Children's furniture; Congenital heart disease; Diagnostic imaging; Evaluation; Female; Genetic disorders; Heart Defects, Congenital - surgery; Heart diseases; Humans; Imaging, Three-Dimensional; Infant; Male; Medicine; Medicine & Public Health; Original Article; Pediatric cardiology; Polyesters - therapeutic use; Sternotomy - methods; Sternotomy - statistics & numerical data; Sternum - surgery; Surgical Wound Dehiscence - prevention & control; Tomography, X-Ray Computed; Treatment Outcome; Vascular Surgery; Poly; Congenital heart disease; Wound healing; lactide; Sternum; Chest wall; Poly-L-lactide
• ISSN: 0172-0643; 1432-1971
• DOI: 10.1007/s00246-019-02212-1

We evaluated the efficacy of bioresorbable sternal reinforcement device (poly-
l
-lactide sternal pins) on sternal healing after median sternotomy in young children (with body weight less than 10 kg) with congenital heart disease (CHD). Data from 85 patients, who underwent CHD surgery through median sternotomy from October 2016 to May 2018, were collected and analyzed. Sternal pins were utilized in 85 patients (10 mm × 1 mm × 1 mm for patients with body weights less than 5 kg and 15 mm × 2 mm × 2 mm for those weighing between 5 and 10 kg) in addition to sternum closure with Ethicon PDS
TM
II running sutures (Group A), while 84 patients received the Ethicon sternal closure (Group B) with no pins. The occurrence of sternal dehiscence, anterior-posterior displacement, and high-low displacement was evaluated by physical examination and three-dimensional computed tomography at one month postoperatively. No anterior-posterior sternal displacement (0%) was observed in Group A, while 10 anterior-posterior displacements (11.9%) were observed in Group B (
P
< 0.01). The number of sternal caudal-cranial displacements in Groups A and B was 4 (4.71%) and 5 (5.35%), respectively (
P
= 0.870). While no sternal dehiscence (0%) was observed in Group A, 7 out of 84 patients (8.33%) in Group B exhibited obvious sternal dehiscence (
P
< 0.01). The bioresorbable poly-
l
-lactide sternal pins reduced an anterior-posterior sternal displacement and sternal dehiscence, which was accompanied by a significant improvement of an early sternal fixation.