Closure Matters: Median Sternotomy Closure Using Non-Metallic Fixation Versus Conventional Steel Wires in Adult Cardiac Surgery

This multi-study review evaluates three studies that exam postoperative outcomes between the use of non-metallic sternal closure techniques compared with conventional stainless steel wires in adult patients undergoing median sternotomy for cardiac surgery. Stainless steel wires are largely considered the gold standard to reapproximate and close the sternum, however, they are falliable. Patients with comorbidities such as obesity, chronic obstructive pulmonary disease, diabetes, or osteoporosis are at an increased risk for postoperative complications such as sternal dehiscence or sternal wound infection, both of which can result in a secondary surgical intervention, longer hospital stays, and overall increased expenses, pain, analgesic requirements, and mortality. Over time, many alternative sternal closure devices have entered the market, however, current research has not revealed another device with superiority to wires and the decision is often guided by provider preference.