Closure techniques for sternal wounds: systematic review of randomized controlled trials

• Grant number: 13/22598-5
• Support Opportunities: Scholarships in Brazil - Scientific Initiation
• Start date: February 01, 2014
• End date: January 31, 2015
• Field of knowledge: Health Sciences - Medicine - Surgery
• Principal Investigator: Regina Paolucci El Dib
• Grantee: Leandro Ramos e Silva
• Host Institution: Faculdade de Medicina (FMB). Universidade Estadual Paulista (UNESP). Campus de Botucatu. Botucatu , SP, Brazil

Abstract

The most frequent method to access the heart and coronary arteries during cardiac surgical procedures involves an incision along the length of the sternum in the midline and the division of the sternum in two equal parts (right and left) - median sternotomy (MST). The standard closure technique after median sternotomy is to join the two parts using steel wires. However, this closure technique has been associated with several serious complications that have prompted surgeons to look for new closure methods. These complications include sternal instability (movement of the sternum at the site of sternal division), dehiscence (re-opening of the wound at the site of the sternal division) and mediastinitis (inflammation of the area below the sternum and between the right and left lungs, the mediastinum). These conditions represent the major causes of morbidity and mortality following cardiac surgery. The title of this systematic review is already registered in the Cochrane Wounds Group of the journal The Cochrane Database of Systematic Reviews with impact factor 5.9. The research project will be conducted in the Department of Anesthesiology and Evidence-Based Medicine Unit, Botucatu Medical School/UNESP, Botucatu-SP. A systematic literature review will be made, according to the methodology of the Cochrane Collaboration, mapping all identified trials in major databases.