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Persistent post sternotomy chest pain: Does sternal wire removal have a role?
Author(s) -
Mohamed Nasr,
AbdelHady M. Taha
Publication year - 2017
Publication title -
journal of the egyptian society of cardio-thoracic surgery
Language(s) - English
Resource type - Journals
eISSN - 2524-1745
pISSN - 1110-578X
DOI - 10.1016/j.jescts.2017.04.004
Subject(s) - medicine , surgery , median sternotomy , anesthesia , sternum , chest pain
Background: Persistent post sternotomy pain is a disabling phenomenon and its cause is unclear. It may be related to hypersensitivity reaction to wire, scar entrapped neuralgia, sternal irritation, chondritis or protruding wires. We aimed to evaluate the effectiveness of sternal wire removal on poststernotomy pain relief.Methods: It is a retrospective study conducted on 48 patients who underwent removal of sternal wires due to persistent post sternotomy anterior chest pain. All wires were removed after exclusion of myocardial ischemia, sternal instability and wound infection. Patients were followed up after 3 months and were divided into 3 groups according to pain response: complete improvement, partial improvement and no improvement.Results: The mean age of patients involved in the study was 39.77 ± 9.44. 66.7% of patients were males. 72.9 %underwent valve surgery. Time lag between primary operation and removal of wires was 23.65 ± 9.26 months. No patients had history of allergy. Regarding response to treatment, patients were asked 3 months after operation about pain relief: 64.6% of patients showed complete improvement, 22.9% had improvement with minimal symptoms, 12.5% showed no improvement thus there was significant improvement in 87.5% of cases.Conclusions: Removal of sternal wires is safe, simple and effective procedure that should be offered to patients with persistent post sternotomy chest pain after exclusion of myocardial ischemia, wound infection and sternal instability

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