Enhancing recovery and outcomes of sternal closure in cardiac surgery: Early results of a 400-patient comparison of suture tapes and steel wires

Background: Conventional steel wires may be inadequate for patients at high risk of sternal complications. We compared steel wires with a novel sternal closure system involving suture tapes, aiming to reduce sternal complications and enhance postoperative recovery, particularly in high-risk patients. Methods: A total of 400 consecutive patients undergoing cardiac surgery via median sternotomy were analyzed retrospectively. Steel wires were used for patients 1 to 200 and suture tapes were used for patients 201 to 400. Preoperative, intraoperative, and postoperative data were compared between the 2 groups of patients. Results: The 2 groups were generally similar in terms of preoperative characteristics. The suture tape group had lower rates of sternal wound infection (1% vs 5%) and sternal dehiscence (0% vs 6%). Postoperative hospital admission also was significantly shorter (7 days vs 10 days). Suture tape patients had significantly less pain at 14-day and 30-day follow-ups, with significantly lower opioid use (125 vs 175 morphine milligram equivalents). Conclusions: Suture tape sternal closure was effective, reproducible, and safe. It showed significant advantages over steel wires, including lower rates of sternal infection, dehiscence, and postoperative pain, as well as decreased opioid usage, and shorter hospital admission and closure times. We demonstrate the significant potential of this novel sternal closure system, especially for patients susceptible to sternal complications. Extended follow-up will be vital to demonstrate long-term efficacy. (JTCVS Techniques 2025;31:97-104)