An Evaluation of Rigid Sternal Fixation in Supporting Bone Healing and Improving Postoperative Recovery

Exclusion Criteria

• •Pre-operative
• •Patients with endstage renal failure who are on dialysis
• •Patients with severe chronic obstructive pulmonary disease (COPD) (FEV1 \< 50% or patients on on-home oxygen)
• •Patients on prescribed pre-operative narcotics
• •Patients taking chronic steroids, biologics acting as immunosuppressants (e.g. Enbrel (etanercept), Humira (adalimumab), Remicade (infliximab), or chemotherapeutics (iv or oral chemotherapeutics for cancer). Patients using a steroid inhaler for asthma should not be excluded.
• •Patients with an active infection as defined by a positive culture
• •Patients with foreign body sensitivity
• •Patients with mental or neurologic conditions who are unwilling or incapable of following postoperative care instructions
• •Patients defined within the New York Heart Association (NYHA) or Canadian Cardiovascular Society (CCS) functional Class IV for congestive heart failure: i.e., patients with cardiac disease resulting in inability to carry on any physical activity without discomfort (CCS ; NYHA)
• •Patients presenting emergent/salvage cardiac acuity as defined per the Society of Thoracic Surgeons (STS) guidelines: i.e., patients undergoing cardiopulmonary resuscitation en route to the operating room or prior to induction of anesthesia (STS)
• •Patients unwilling or unable to return for follow-up
• •Operative
• •Patients requiring delayed sternotomy closure
• •Patients with an off-midline sternotomy reducing the bony margin between a SternaLock screw body and an osteotomy to within 2mm or less
• •Patients presenting intra-operative conditions that in the opinion of the treating surgeon would require or preclude the use of either wire cerclage or rigid fixation, or who are not able to be plated or wired per the protocol (e.g. patients who in the opinion of the surgeon have insufficient quantity of quality of sternal bone; redo sternotomy with excessive fibrous tissue)
• •Use of non resorbable (beeswax) bonewax
• •Intraoperative death prior to device placement