PDF(Pubmed)
Abstract：
UNASSIGNED: Sternal dehiscence is frequently associated with wire-based closures cutting through fragile bone, allowing sternal motion, separation, and infection. We investigated whether bone cutting could be limited by using a newly available mesh suture with improved force distribution.
UNASSIGNED: Five sternal models were closed using 8 interrupted single sternal wires, double sternal wires, braided poly(ethylene terephthalate) sutures, single-wrapped mesh sutures, or double-wrapped mesh sutures. To simulate chest-wall forces, closed sternal models were pulled apart using 1020 N of axial force applied incrementally. Double sternal wire and double-wrapped mesh suture were further compared by closing 3 new models with each material and subjecting these models to cyclic loading cycles, simulating breathing and coughing. Image analysis of needle hole size measured \"bone cutting\" by each closure material and sternal distraction as a function of force.
UNASSIGNED: All models exhibited maximal separation at the xiphoid. During axial loading, needle hole size increased 7.2% in the double-wrapped mesh suture model and 9.2% in the double-wire model. Single-wrapped mesh suture, single wires, and braided poly(ethylene terephthalate) extended needle hole size by 6.7%, 47.0%, and 168.3% of original size, respectively. The double-wire model resisted sternal distraction best, separating 0.285 cm at the xiphoid. During cyclic loading, mesh suture exhibited significantly less bone cutting (P = .02) than double wire, with comparable levels of sternal separation (P = .07).
UNASSIGNED: Mesh suture may resist bone cutting seen in sternal wire closure in bone models with comparable distraction to currently used sternal closure methods.
UNASSIGNED: Five sternal models were closed using 8 interrupted single sternal wires, double sternal wires, braided poly(ethylene terephthalate) sutures, single-wrapped mesh sutures, or double-wrapped mesh sutures. To simulate chest-wall forces, closed sternal models were pulled apart using 1020 N of axial force applied incrementally. Double sternal wire and double-wrapped mesh suture were further compared by closing 3 new models with each material and subjecting these models to cyclic loading cycles, simulating breathing and coughing. Image analysis of needle hole size measured \"bone cutting\" by each closure material and sternal distraction as a function of force.
UNASSIGNED: All models exhibited maximal separation at the xiphoid. During axial loading, needle hole size increased 7.2% in the double-wrapped mesh suture model and 9.2% in the double-wire model. Single-wrapped mesh suture, single wires, and braided poly(ethylene terephthalate) extended needle hole size by 6.7%, 47.0%, and 168.3% of original size, respectively. The double-wire model resisted sternal distraction best, separating 0.285 cm at the xiphoid. During cyclic loading, mesh suture exhibited significantly less bone cutting (P = .02) than double wire, with comparable levels of sternal separation (P = .07).
UNASSIGNED: Mesh suture may resist bone cutting seen in sternal wire closure in bone models with comparable distraction to currently used sternal closure methods.
摘要：
■胸骨开裂通常与基于金属丝的闭合物穿过脆弱的骨骼有关，允许胸骨运动，分离,和感染。我们调查了是否可以通过使用具有改善力分布的新可用网状缝线来限制骨切割。
■使用8根中断的单根胸骨丝闭合了5个胸骨模型，胸骨双丝,编织聚对苯二甲酸乙二醇酯缝线,单包裹网状缝线，或双包裹网状缝线。要模拟胸壁力，使用递增施加的1020N轴向力将闭合的胸骨模型拉开。通过用每种材料闭合3个新模型并对这些模型进行循环加载循环，进一步比较了双胸骨钢丝和双缠绕网状缝合线。模拟呼吸和咳嗽。通过每种闭合材料和胸骨牵张力测量的“骨切割”大小的图像分析。
■所有模型在剑突处表现出最大分离。在轴向加载期间，双包裹网状缝线模型中的针孔尺寸增加了7.2%,双线模型中的针孔尺寸增加了9.2%.单包裹网状缝合线，单线,编织聚对苯二甲酸乙二醇酯延长了6.7%的针孔尺寸，47.0%,原始尺寸的168.3%，分别。双线模型最好地抵抗胸骨牵引，在剑突分离0.285厘米。在循环加载期间，网状缝合线显示出比双线显著更少的骨切割(P=0.02)，胸骨分离水平相当（P=0.07）。
■网状缝线可能会抵抗骨模型中胸骨丝闭合中所见的骨切割，其牵张力与当前使用的胸骨闭合方法相当。
■使用8根中断的单根胸骨丝闭合了5个胸骨模型，胸骨双丝,编织聚对苯二甲酸乙二醇酯缝线,单包裹网状缝线，或双包裹网状缝线。要模拟胸壁力，使用递增施加的1020N轴向力将闭合的胸骨模型拉开。通过用每种材料闭合3个新模型并对这些模型进行循环加载循环，进一步比较了双胸骨钢丝和双缠绕网状缝合线。模拟呼吸和咳嗽。通过每种闭合材料和胸骨牵张力测量的“骨切割”大小的图像分析。
■所有模型在剑突处表现出最大分离。在轴向加载期间，双包裹网状缝线模型中的针孔尺寸增加了7.2%,双线模型中的针孔尺寸增加了9.2%.单包裹网状缝合线，单线,编织聚对苯二甲酸乙二醇酯延长了6.7%的针孔尺寸，47.0%,原始尺寸的168.3%，分别。双线模型最好地抵抗胸骨牵引，在剑突分离0.285厘米。在循环加载期间，网状缝合线显示出比双线显著更少的骨切割(P=0.02)，胸骨分离水平相当（P=0.07）。
■网状缝线可能会抵抗骨模型中胸骨丝闭合中所见的骨切割，其牵张力与当前使用的胸骨闭合方法相当。
