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A new technical approach for sternal closure with suture anchors (Dogan technique).

Dogan OF, Oznur A, Demircin M.

Hacettepe University Faculty of Medicine, Department of Cardiovascular Surgery, Ankara, Turkey. ofdogan@hacettepe.edu.tr

OBJECTIVES: Various methods for sternal approximation have been described previously. Some patients undergoing these procedures are at risk for sternal dehiscence and mediastinitis. We used a different method, with a suture anchor system, for median sternotomy closure as an alternate technique in patients with a high risk of postoperative sternal dehiscence and sternal nonunion. MATERIAL AND METHOD: Suture anchor systems have been developed principally for the fixation of tendons or ligaments to the bone. We first used the suture anchor system for median sternotomy closure, although it has been frequently used in various orthopedic surgical procedures. In this report, we describe the use, after fresh cadaveric tests, of an alternative technique in a patient undergoing coronary artery bypass grafting. RESULTS: There were no complications due to the suture anchor device, and successful application was performed for sternotomy fixation after surgical procedure in a patient. The standard techniques have several disadvantages, such as osteomyelitis, chondritis, cutting into the sternum and sternal dehiscence, prolonged hospitalization, and increased mortality and morbidity due to the listed complications, but these devices may protect the wire from cutting into the sternal bone. CONCLUSION: We propose suture anchors for reapproximation of the sternum to decrease the complications related to surgical steel wires. We therefore consider this technique to be easy, safe, and effective in patients with diabetes mellitus or severe osteoporosis considered to have risk for sternal dehiscence postoperatively. Another advantage of this suture system is that the titanium wire makes it more magnetic resonance compatible than systems using surgical steel wire.
Heart Surg Forum. 2004 Jul 1;7(4):E328-32.
Various methods for sternal approximation have been described previously. Some patients undergoing these procedures are at risk for sternal dehiscence and mediastinitis. We used a different method, with a suture anchor system, for median sternotomy closure as an alternate technique in patients with a high risk of postoperative sternal dehiscence and sternal nonunion. MATERIAL AND METHOD: Suture anchor systems have been developed principally for the fixation of tendons or ligaments to the bone. We first used the suture anchor system for median sternotomy closure, although it has been frequently used in various orthopedic surgical procedures. In this report, we describe the use, after fresh cadaveric tests, of an alternative technique in a patient undergoing coronary artery bypass grafting.RESULTS: There were no complications due to the suture anchor device, and successful application was performed for sternotomy fixation after surgical procedure in a patient. The standard techniques have several disadvantages, such as osteomyelitis, chondritis, cutting into the sternum and sternal dehiscence, prolonged hospitalization, and increased mortality and morbidity due to the listed complications, but these devices may protect the wire from cutting into the sternal bone.

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Bu makaleden alıntı yapmak için alıntı yapılan yazıya aşağıdaki ibare eklenmelidir : "A new technical approach for sternal closure with suture anchors (Dogan technique)." başlıklı makalenin tüm hakları yazarı Doç.Dr.Ömer Faruk DOGAN'e aittir ve makale, yazarı tarafından TavsiyeEdiyorum.com (http://www.tavsiyeediyorum.com) kütüphanesinde yayınlanmıştır. Bu ibare eklenmek şartıyla, makaleden Fikir ve Sanat Eserleri Kanununa uygun kısa alıntılar yapılabilir, ancak yazarının izni olmaksızın makalenin tamamı başka bir mecraya kopyalanamaz veya başka yerde yayınlanamaz.

Doç.Dr.Ömer Faruk DOGAN Tarafından Yazılan Diğer Makaleler: Effect Of Cardiopulmonary Bypass On Plasma Levels Of Lipoprotein (A) İn Hypercholesterolemic Patients Surgical Management Of İnfants With Congenital Lobar Emphysema And Concomitant Congenital Heart Disease. Assessment Of The Radial Artery And Hand Circulation By Computed Tomography Angiography: A Pilot Study. The Use Of Suture Anchors For Sternal Nonunion As A New Technical Approach (Demircin-Dogan Technique). Comparison Of The Pretreatment Effects Of Mixed Vasodilators (3-D Solution) On Radial And İnternal Thoracic Arteries By Using A 3-Dimensional Anaglyph Electron Microscope Technique. The Changes And Effects Of The Plasma Levels Of Tumor Necrosis Factor After Coronary Artery Bypass Surgery With Cardiopulmonary Bypass. Peripheral Gangrene Associated With Kawasaki Disease And Successful Management Using Prostacycline Analogue: A Case Report. Demonstration Of Coronary Arteries And Major Cardiac Vascular Structures İn Congenital Heart Disease By Cardiac Multidetector Computed Tomography Angiography. Predictive Significance Of Plasma Levels Of İnterleukin-6 And High-Sensitivity C-Reactive Protein İn Atrial Fibrillation After Coronary Artery Bypass Surgery. Preoperative Fibrinogen Levels As A Predictor Of Postoperative Bleeding After Open Heart Surgery.