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Combination plate and band fixation for primary closure in bilateral lung transplantation
Author(s) -
Boudreaux Joel C.,
Urban Marian,
Berkheim David B.,
Moulton Michael J.,
Small Bronwyn L.,
Strah Heather M.,
Siddique Aleem
Publication year - 2021
Publication title -
journal of cardiac surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.428
H-Index - 58
eISSN - 1540-8191
pISSN - 0886-0440
DOI - 10.1111/jocs.15729
Subject(s) - medicine , surgery , complication , fixation (population genetics) , malunion , retrospective cohort study , wound dehiscence , transplantation , dehiscence , nonunion , population , environmental health
Abstract Background Sternal complications are common following transverse thoracosternotomy in patients undergoing bilateral lung transplantation. We present a single‐institution experience using a next generation rigid fixation system for primary sternal closure following transverse sternotomy for bilateral lung transplantation. Methods Retrospective review was performed on all patients who had bilateral sequential lung transplants utilizing a transverse thoracosternotomy from 2016 to 2020. Demographics, baseline characteristics, peri‐operative data, and outcomes were collected, reviewed and summarized. Two groups of patients were identified: wire cerclage (Group A), combination plate‐and‐band rigid fixation (Group B). The primary outcome was sternal complications, which were divided into mechanical and non‐mechanical. Results Twenty‐two patients met inclusion criteria. Three patients (13.6%) were in Group A, nineteen patients (86.4%) in Group B. Two patients in each Group A (66.6%) and Group B (10.5%) experienced a sternal complication. Sternal complications included sternal dehiscence (2), sternal malunion (1), and surgical site infection (1). One patient with plate‐and‐band fixation (5.2%) had a mechanical sternal complication. Three patients required reoperation secondary to sternal complication. Conclusions The utilization of a combination plate‐and‐band rigid fixation system for primary closure is safe and may be an effective method to reduce sternal complications following transverse thoracosternotomy for lung transplantation.