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Sternal wires are used to hold the sternum together after a procedure where it is cracked to access the chest cavity. This is necessary in traditional open heart surgical procedures where the doctor needs to be able to clearly visualize the surgical site. After the procedure, the patient will be monitored and once the sternum is healed, the wires can be removed. This requires a second procedure, which usually lasts less than an hour, to open the incision and access the wires.
The bones of the rib cage provide a strong but elastic container for the heart and lungs, which need to be able to move while they function while still being protected from impact. In some types of surgery, the sternum is cut apart to allow the surgeon to open the rib cage. After surgery, the sternum needs to be firmly wired back together to hold it while the patient heals. Sternal wires can be looped or wound around the sternum to stabilize the bone and prevent spontaneous separation of the wound under strain.
This separation, called dehiscence, is a particular concern with sternal injuries because the bone is subject to high stress from both within and without. While the heartbeat may appear relatively subtle from the outside of the chest, it actually moves around quite energetically, and the constant inflation and deflation of the lungs adds strain. Pressures from the outside can include compression when patients bend, as well as impact strain from falling or being hit in the chest.
After placing sternal wires to hold the bone together, the surgeon can use glue or specialized bandages to close the incision. Stitches or staples may be used in some cases if the doctor prefers them, although they can make the scarring from the surgery much worse. During the process of healing, the patient’s sternal wires can be checked with x-rays to make sure they are not migrating, damaging the bone, or separating, indicating that the sternum may be pulling apart.
As long as sternal wires are in place, patients will set off metal detectors. It can help to carry a note from a physician with images to explain the situation so patients will be able to move freely through security. Once the patient is fully healed, if the wires appear to be loosening, or if the patient reports symptoms like pain and soreness, a follow-up surgery can be scheduled to take them out.
@irontoenail - Well, I do wonder how much longer this is going to be at all common. Keyhole surgery is becoming more and more the norm and with the abilities that robotics are making possible, I can see a time when you wouldn't need to open up the sternum at all, because the instruments could slip between the ribs to do the work.
This wouldn't be possible for everything, of course. But, once you've got instruments that can see around corners and operate with precision through the smallest holes, there's no reason to create so much trauma in the body in order to heal it.
It never occurred to me that you'd need to wire the sternum back together after completing chest surgery, but of course you would have to. It would either be that or wrapping the whole chest in a cast, which wouldn't be very practical, considering that the patient still have to be able to breathe and all.
It just seems like such a strange idea, probably because splitting open that area of the body seems so drastic in the first place. Maybe I just don't like to think of the heart and lungs being exposed so much.
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