Turkish Journal of
GERIATRICS

Süleyman Demirel Üniversitesi Tıp Fakültesi Göğüs Kalp ve Damar Cerrahisi Anabilim Dalı, Isparta
Süleyman Demirel Üniversitesi Tıp Fakültesi, Anesteziyoloji ve Reanimasyon Anabilim Dalı-Isparta Midline sternotomy is the approach most commonly used in patients undergoing operation with cardiopulmonary by-pass. The end of operation, is conventionally performed using wires of surgical steel that are passed through the sternal plates. A complication that may arise is sternal instability, either with or without concurrent infection. Sternal wound infection is a important cause of morbidity and mortality in patients undergoing cardiac surgery via midline sternotomy. This complication may be the result of unstable osteosynthesis, caused by the sternal wire cutting into the cortical layers. Osteoporosis may be a significant factor in unfavorable results following open cardiac surgery. The effect of the system is that the staple transfers the load from a single point to the area of the back of the staple and , physically prevents the wire from cutting into the anterior cortical bone layer. The method is presented here whereby the conventional sternal closure is reinforced, and an increase in the available force between the sternal plates is provided in the elderly. Between November 2000 and February 2001, 20 elderly patients underwent various cardiac procedures via midline sternotomy under cardiopulmonary bypass at Suleyman Demirel University, School of Medicine, Department of Cardiovascular Surgery. The Reinforced Sternal Closure System was applied in all patients. We believe that, this method is useful in elderly with osteoporosis after midline sternotomy. Keywords : Open heart surgery, Sternotomy, Elderly, Sternal closure technique, Stapler