# Which Sternal Closure Technique is More Beneficial in Cardiac Surgery: Simple Wire, Figure-of-8, or Their Combination?

## TL;DR

This study compares three sternal closure techniques used in cardiac surgery and finds that the combined technique leads to shorter hospital stays without increasing complications.

## Contribution

The study provides evidence that a combined sternal closure technique reduces hospital stay duration without affecting complication rates.

## Key findings

- No significant differences in sternal complications were found between the three closure techniques.
- The combined closure technique was associated with a shorter hospital stay compared to the other techniques.
- Patient outcomes like infection rates and mortality were similar across all groups.

## Abstract

The aims of this study are to compare sternal closure techniques (single,
figure-of-8, and combined use) in patients undergoing cardiac surgery and to
investigate their relationship with postoperative sternal complications.

Between 2023 and 2024, 645 patients (470 males; mean age 58.5 ± 11.1
years) who underwent cardiac surgery were evaluated. The patients were
divided into three groups: Group 1, simple wire (n = 141); Group 2,
figure-of-8 (n = 224); and Group 3, combination of these two techniques (n =
280). Preoperative and perioperative data, postoperative complications, and
sternal complications were compared between these groups.

Result: The distribution ratio of the groups is 141 (22%), 224 (35%), and 280
(43%) in Groups 1, 2, and 3, respectively. There was no significant
difference between the groups regarding basic demographic characteristics,
comorbidities, and operative data. There was no difference between the
groups in terms of postoperative exploration, delayed chest closure,
subxiphoid decompression, superficial sternal wound infection (SSWI), deep
sternal wound infection (DSWI), vacuum-assisted closure usage, intubation
time, intensive care unit stay, and mortality. The hospital stay was found
to be shorter in Group 3 compared to the other groups (median 8 days - 7
days, P = 0.02).

In patients undergoing cardiac surgery, we found no difference in sternal
complications (DSWI, SSWI) between the three most commonly used closure
techniques (simple wire, figure-of-8, and their combination). We found that
the length of hospital stay was shorter in patients with the combined
technique than in the other two techniques.