@article{Mourad_Ali_2021, title={Interlocking Multi-Twisted Wires Versus Interrupted Simple Sternal Wires for Closure of Median Sternotomy}, volume={24}, url={https://journal.hsforum.com/index.php/HSF/article/view/3663}, DOI={10.1532/hsf.3663}, abstractNote={<p class="p1"><span class="s1"><strong>Background</strong>: Although closure of a sternotomy incision is usually a simple procedure, failure to do so (sternal dehiscence) is a serious complication and is an independent factor that poses a high degree of morbidity or mortality after open heart surgery. Instability of the bone fragments can lead to complete sternal breakdown, sternal wound infection, and mediastinitis. The stainless-steel encircling wire used as either interrupted simple sutures or as figure of eight sutures is the current standard method of median sternotomy closure. Interlocking multi-twisted sternal wire closure is an alternative that provides rigid sternal fixation. We aim to identify the best method of sternal closure in order to implement it as a standardised protocol for our department.</span></p> <p class="p1"><span class="s1"><strong>Methods</strong>: Two-hundred patients aged 18-70 years were undergoing cardiac surgeries at Ain Shams University hospitals. They were divided into two groups: Group I included 100 patients with sternal closure using simple wire, and group II included 100 patients with sternal closure using interlocking multi-twisted wires. The day 7, 1 month, and 3 months sternal instability, superficial wound infection, ventilation time, cross-clamp time, length of ICU stay, and length of hospital stay were analyzed.</span></p> <p class="p1"><span class="s1"><strong>Results</strong>: The incidence of sternal instability on the 7th day, 1 month, and 3 months was significantly higher in the simple wire closure group (<em>P</em> &lt; 0.05). However, incidence of superficial wound infection, length of ICU stay, and duration of mechanical ventilation were comparable between the two groups.</span></p> <p class="p1"><span class="s1"><strong>Conclusion</strong>: The interlocking multi-twist is a safe, effective, and easily reproducible method for preventing sternal dehiscence.</span></p>}, number={2}, journal={The Heart Surgery Forum}, author={Mourad, Faisal and Ali, Ihab}, year={2021}, month={Apr.}, pages={E363-E368} }