Universität zu Köln

Leinberger, Tetyana, Heilmann, Claudia, Sorg, Stefan, Mueller, Matthias, Kueri, Sami, Schmoor, Claudia, Siepe, Matthias ORCID: 0000-0003-3305-9343 and Beyersdorf, Friedhelm (2018). The COSTA Study: Sternal Closure in High-Risk Patients - A Prospective Randomized Multicenter Trial. Thorac. Cardiovasc. Surg., 66 (6). S. 508 - 517. STUTTGART: GEORG THIEME VERLAG KG. ISSN 1439-1902

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Abstract

Background Median sternotomy in patients with risk factors for wound healing is associated with high rates of postoperative wound infections and sternum instability. Methods A total of 338 patients with elective first median sternotomy and at least four predefined risk factors were randomized between Sternal Talon (Gebruder Martin GmbH & Co. KG-KLS Martin Group, Tuttlingen, Germany) and wire cerclage. The primary end point was mediastinitis and/or sternal instability within 30 +/- 5 days, and the secondary end points were mediastinitis and/or sternal instability within 60 +/- 5 days; incidence of pneumonia during hospitalization within the first 30 (+/- 5) days and chest pain intensity. Results The primary end point was reached in 10 Sternal Talon and 7 wire cerclage patients (6.2 vs. 4.7%, odds ratio [OR]: 1.3, 95% confidence interval [CI]: 0.5-3.6, p = 0.57) from 338 randomized patients. Sternal Talon group, n = 170 patients versus wire cerclage group, n = 168 patients. The differences between treatment groups with regard to the incidence of mediastinitis/sternum instability within the first 60 (+/- 5) days after the primary sternum closure and the incidence of pneumonia during the hospitalization within the first 30 (+/- 5) days were not statistically significant, either. We observed comparable rates of superficial surgical site infection (SSI) in Sternal Talon and wire cerclage patients (16.1 vs. 12.1%, OR: 1.4, 95% CI: 0.7-2.7, p = 0.31). Conclusion According to these data, there is no statistically significant difference between Sternal Talon closure and wire cerclage in reducing the incidence of mediastinitis and superficial SSI after primary closure of median sternotomy in high-risk patients.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Leinberger, Tetyana UNSPECIFIED UNSPECIFIED UNSPECIFIED Heilmann, Claudia UNSPECIFIED UNSPECIFIED UNSPECIFIED Sorg, Stefan UNSPECIFIED UNSPECIFIED UNSPECIFIED Mueller, Matthias UNSPECIFIED UNSPECIFIED UNSPECIFIED Kueri, Sami UNSPECIFIED UNSPECIFIED UNSPECIFIED Schmoor, Claudia UNSPECIFIED UNSPECIFIED UNSPECIFIED Siepe, Matthias UNSPECIFIED orcid.org/0000-0003-3305-9343 UNSPECIFIED Beyersdorf, Friedhelm UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-174764
DOI:	10.1055/s-0037-1618584
Journal or Publication Title:	Thorac. Cardiovasc. Surg.
Volume:	66
Number:	6
Page Range:	S. 508 - 517
Date:	2018
Publisher:	GEORG THIEME VERLAG KG
Place of Publication:	STUTTGART
ISSN:	1439-1902
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language MEDIAN STERNOTOMY; WOUND COMPLICATIONS; CARDIAC-SURGERY; PREVENTION; INFECTION; FIXATION; OSTEOSYNTHESIS; DEHISCENCE; TALON; WIRES Multiple languages Cardiac & Cardiovascular Systems; Respiratory System; Surgery Multiple languages
Refereed:	Yes
URI:	http://kups.ub.uni-koeln.de/id/eprint/17476