Analysis of types of sternorrhaphy in the experiment
Abstract
Choosing the best material and method for restoring
the integrity of the sternum will improve the quality of patient care and help
prevent infectious postoperative complications associated with access.
Material
and methods. In an
experiment was studied on an artificial model of the sternum with imitation of
a median sternotomy, a single suture and two variants of the figure-of-eight
(pericostal and peristernal) and two types of suture mat erial – steel wire
(Ethicon steel, Johnson & Johnson, USA) and polyamide monofilament
(Medeng.ru, Russia). A comparative analysis of the strength of joints and
suture material, as well as the elasticity of the polyamide thread under a
lateral load of 200 N, was carried out.
Results. The rupture of the steel wire occurs at 1270 N, the
polyamide thread – at 544 N. Under a load of 200 N, the diastases between the
halves of the sternum with a peristernal connection of the figure-of-eight was
1.26±0.15 mm, with a single suture – 1.62±0.11 mm, and with figure-of-eight
pericostal type of connection – 2.77±0.18 mm. With the formation of a diastases
of 3 mm between the edges of the model, connected by a polyamide thread, after
the termination of the force, a complete recovery occurs within 330 seconds.
Conclusion. The “figure eight” peristernal suture withstands the
greatest load when using steel and polyamide threads. When exposed to a lateral
load of 200 N, there was no statistically significant difference between simple
single and peristernal of the figure-of-eight. The pericostal method of
connection can be used when it is necessary to avoid stress on the bone tissue
of the sternum and to strengthen transverse fractures.
The
elasticity of the polyamide thread allows to level the deformation within 3 mm,
which occurs when a force of 200 N is applied to the seam, which will reduce
the risk of complications from the access side.
Keywords:sternotomy, experiment; sternum, steel wire; polyamide monofilament; figure-of-eight peristernal suture; figure-of-eight pericostal suture
Funding. The study had no sponsor support.
Conflict of interest. The authors declare no conflict of interest.
For citation: Shneider V.E., Sokolova V.V., Muratov K.R., Mamedov
G.M., Yanin E.L. Analysis of types of sternorrhaphy in the experiment. Clinical
and Experimental Surgery. Petrovsky Journal. 2023; 11 (2): 68–74. DOI: https://doi.org/10.33029/2308-1198-2023-11-2-68-74
(in Russian)
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