Journal article
Characterizing twist-to-writhe wiring technique for sternal closure following median sternotomy: biomechanical analysis
Indian journal of thoracic and cardiovascular surgery, v 42(6), pp 778-782
Jun 2026
PMID: 42152839
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Abstract
Objective
Wire fracture during sternal closure following median sternotomy poses significant risks, including sternal dehiscence. This study introduces and evaluates a novel “twist-to-writhe” technique aimed at reducing the risk of wire fracture while maintaining adequate sternal closure.
Methods
Ten foam sternum models per group were used and bisected to simulate median sternotomy. Each foam sternal model was closed with five sternal wires using either the twist-to-writhe (experimental) technique or the traditional (control) technique. In the twist-to-writhe method, wire ends that were cleaved were left at 10 centimeters (cm) before twisting with a wire twister. In the traditional method, wire ends were cut to 1 cm before twisting. Compressive forces at several sternal points were measured.
Results
The average compressive forces across four key sternal points were similar between the twist-to-writhe and traditional methods (167.45 ± 5.96 newton (N) vs. 172.92 ± 7.41 N, p = 0.086). No significant differences in force application were observed at the manubrium, upper mid-sternum, lower mid-sternum, or xiphoid process (p > 0.05 for all comparisons).
Conclusion
The twist-to-writhe technique may reduce the incidence of wire fractures without compromising sternal approximation or closure quality. Further clinical validation is needed to confirm these findings.
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Details
- Title
- Characterizing twist-to-writhe wiring technique for sternal closure following median sternotomy: biomechanical analysis
- Creators
- Peter Dong Won Cho - Drexel University, College of MedicineAmba Viswanathan - Drexel University, Biochemistry and Molecular BiologyLeigham Breckenridge - Reading HospitalKaty Strand - University of PennsylvaniaMichael Hast - University of PennsylvaniaUday Dasika - Reading Hospital
- Publication Details
- Indian journal of thoracic and cardiovascular surgery, v 42(6), pp 778-782
- Resource Type
- Journal article
- Language
- English
- Academic Unit
- Biochemistry and Molecular Biology; College of Medicine
- Web of Science ID
- WOS:001695804100001
- Scopus ID
- 2-s2.0-105030817226
- Other Identifier
- 991022180705904721
InCites Highlights
Data related to this publication, from InCites Benchmarking & Analytics tool:
- Collaboration types
- Domestic collaboration
- Web of Science research areas
- Cardiac & Cardiovascular Systems