Pericostal sutures to reinforce sternal closure after cardiac surgery

Background and Aim of the Study: An increasing number of elderly and medically complex patients are undergoing cardiac surgery and are at increased risk for sternal dehiscence. A technique of sternal closure reinforcement with pericostal wires is described, and results are reviewed. Methods: After placement of the standard peristernal wires, one or two sets of pericostal wires were placed around ribs in the mid-portion of the sternotomy to reinforce the closure. A retrospective study over a 6-year period was carried out to determine the incidence of sternal dehiscence and any associated complications. Pericostal wires were used in well over 50% of cases. Results: The incidence of sternal dehiscence was 4 out of 1048 operations (0.38%). No adverse effects of the pericostal wires were identified. Conclusions: Frequent use of pericostal wires is associated with a low incidence of sternal dehiscence.