Comparison of Braided Polyester Versus Standard Stainless Steel Wire Sternal Closure in Open Heart Patients

Background: Postoperative complications associated with poor sternal fixation can result in morbidity, mortality, and considerable resource utilization.Ideal sternal closure is not the only but an important factor to decrease postoperative morbidity and mortality.The ideal sternal closure should ensure stability, reduced rate of postoperative complications, and a short hospitalization period, alongside cost-effectiveness.Objective: To compare two sternal closure techniques; steel wire closure vs braided polyester No.5 sutures, regarding sternal stability, early and late postoperative pain, reoperation for bleeding, sinus formation, and superficial and deep sternal infection.Patients and Methods: This was a prospective, non-randomized, comparative study that enrolled a total of 118 patients who underwent open heart surgery via sternotomy, divided into 2 equal groups: Group A: 59 Patients with sternum closure by braided polyester No.5, and Group B: 59 patients with sternum closure by standard stainless-steel wire.Results: Group A showed no sinus complications compared to group B in which 4 patients developed postoperative sinus, p value = 0.03, reoperation rate for bleeding was one patient in Group A (1.7%) vs four patients in Group B (6.8%), p value = 0.045, and frequency of late postoperative pain (one patient in group A (1.7%) vs four patients in group B (6.7%), P value 0.03, the difference proved to be statistically significant.In Group A, one out of 58 patients (1.7%) had sternal instability, while in group (B) 3 out of 59 (5.0%) were found unstable, and difference was statistically insignificant (P value 0.648).Conclusion: We found that braided polyester sutures No.5 can be used as a safe alternative to standard stainless-steel wire.Beside this material has proven lower rate of sinus formation and less late complications.