SternaSafe improves post-operative respiratory function and wound healing in patients after Coronary Artery Bypass Grafting

Abstract

Background: As the risk profile of patients undergoing contemporary cardiac surgery rises, it is inadvertent that the incidence of sternal wound complications increases. Despite the advances in many aspects of cardiac surgery, sternal closure technique has remained stagnant and there has been a lack of innovation in addressing sternal wound complications. In this study, we aim to assess the effectiveness of using a novel adjustable chest binder (SternaSafeTM, Holland Trade Medical Ltd, The Netherlands) as an adjunct to conventional wound care in post median sternotomy coronary artery bypass grafting (CABG) patients. Methods and Results: We conducted a randomized controlled study with two groups. Group A (Control) underwent routine closure with stainless steel wires and no chest binder while Group B (Intervention) underwent routine closure with application of SternaSafeTM from post-operative day 1 if the patient was extubated. Patients who underwent emergent surgery, in whom the internal mammary artery was not harvested, who had previous open heart surgery or prior radiotherapy to the chest, who had obesity (defined as BMI >35) and those who had ejection fraction of <25% were excluded from the study. A total of 21 patients completed the study and 20 were analysed after propensity matching. FEV1 and FVC were significantly better in the intervention group on the 1st, 3rd and 5th post-operative days. Sternal wound healing was assessed after 30 days using the Southampton Wound Score which favoured the intervention group. There was no difference in the pain score after 90 days. Conclusion: The adjustable chest binder (SternaSafeTM) improved post-operative respiratory function and wound healing in CABG patients. There was no clinical difference in patient’s outcome at 3 months.