STERNAL CERCLAGE BAND SYSTEM: PRELIMINARY RESULTS OF PADUA EXPERIENCE

Background: Sternotomy is considered the gold standard incision in cardiac surgery. After surgery, the two sternal halves must be tightly reapproximated for proper healing, avoiding instability and wound infection. Stainless steel wires represent the gold standard, but ultra high moleculare weight polyethylene (UHMWPE) bands have been introduced into clinical practice due to their elasticity, stiffness and strength. Aim: To report our center’s experience with UHMWPE band system Methods: Prospective observational study including patients undergoing cardiac surgery through median sternotomy. Endpoints: severe complications (mediastinitis, osteomyelitis) and mild complications (superficial dehiscence). Results: In 21 patients (15 males, median age 65) band system was used (9 CABG, 2 AVR, 1 MVR, 2 MVP, 2 AAR, 5 combined), from 03/08/2023 to 14/12/2023. Median BMI was 26.4Kg/m2. Diabetes was present in 4 (19%), BPCO in 1 (4.8%), asthma in 1 (4.8%), active smoking in 8 (38%), osteoporosis in 2 (9.5%). Median length of hospitalization was 21 days. Both overall mortality and mortality related to the band system was null. There was no case of severe complications, of surgical revision for band-related bleeding or of re-osteosynthesis with steel wires. There were 2 (9.5%) cases of superficial dehiscence with bone instability, one of which complicated by infection and need for antibiotic. Both of them underwent closure through tightening of the same bands. Other 6 patients had only minor superficial dehiscence, without bone instability, and needed mild medications during outpatient visits. Conclusions: The band system is a solid and efficient method for sternal closure after median sternotomy.