Use of bone chips to improve sternum bone tissue regeneration after median sternotomy in patients with a high risk of sternal dehiscence in cardiac surgery (case report)
https://doi.org/10.29001/2073-8552-2025-40-2-142-149
Abstract
Median sternotomy remains the approach of choice for cardiac, great vessel, and pulmonary surgeries. According to data analysis, postoperative complications after median sternotomy, such as incompetence of the sternal sutures, acute mediastinitis and osteomyelitis of the sternum and ribs, occur in 2–6% of patients. The article discusses a clinical case of the successful use of a new technique aimed at accelerating the processes of regeneration of sternum bone tissue using osteoplastic material in a patient at high risk of sternal dehiscence. The effectiveness of this technique opens up the possibility of its widespread implementation in clinical practice.
About the Authors
M. S. KuznetsovRussian Federation
Mikhail S. Kuznetsov, Cand. Sci. (Med.), Research Scientist, Department of Cardiovascular Surgery
111a, Kievskaya str., Tomsk, 634012
Sh. D. Akhmedov
Russian Federation
Shamil D. Akhmedov, Dr. Sci. (Med.), Professor, Leading Research Scientist, Department of Cardiovascular Surgery
111a, Kievskaya str., Tomsk, 634012
V. V. Shipulin
Russian Federation
Vladimir V. Shipulin, Research Scientist, Laboratory of Radionuclide Research Methods
111a, Kievskaya str., Tomsk, 634012
V. E. Alyamkin
Russian Federation
Vadim E. Alyamkin, Medical Resident, Department of Cardiovascular Surgery
111a, Kievskaya str., Tomsk, 634012
I. L. Bukhovets
Russian Federation
Irina L. Bukhovets, Dr. Sci. (Med.), Senior Research Scientist, Department of X-ray and Tomographic Diagnostic Methods
111a, Kievskaya str., Tomsk, 634012
A. M. Gusakova
Russian Federation
Anna M. Gusakova, Cand. Sci. (Pharm.), Senior Research Scientist, Department of Functional and Laboratory Diagnostics
111a, Kievskaya str., Tomsk, 634012
N. L. Afanasyeva
Russian Federation
Natalia L. Afanasyeva, Cand. Sci. (Med.), Cardiologist, Department of Cardiovascular Surgery
111a, Kievskaya str., Tomsk, 634012
B. N. Kozlov
Russian Federation
Boris N. Kozlov, Dr. Sci. (Med.), Head of the Department of Cardiovascular Surgery
111a, Kievskaya str., Tomsk, 634012
References
1. Hernández-Zamora R.E., Sotelo-Carbajal J., Martínez-Maya G., GarcíaLedezma A., Román-Matus A., Torres-Salazar Q.L. Sternal dehiscence, a reconstructive challenge. Case report. Int. J. Surg. Case Rep. 2023;111:108926. https://doi.org/10.1016/j.ijscr.2023.108926
2. Kartashov A.A. E`ffektivnost` i rezul`taty` aortokoronarnogo shuntirovaniya u bol`ny`x ishemicheskoj bolezn`yu serdcza s izby`tochnoj massoj tela na fone insulinorezistentnosti: autoref. dis. … kand. med. nauk. M., 2015:29. (In Russ.) URL: https://www.dissercat.com/content/effektivnost-i-rezultaty-aortokoronarnogo-shuntirovaniya-ubolnykh-ishemicheskoi-boleznyu/read (03.02.2015).
3. Staedt H., Dau M., Schiegnitz E., Thiem D.G.E., Tagadiuc O., Palarie V. et al. A collagen membrane influences bone turnover marker in vivo after bone augmentation with xenogenic bone. Head Face Med. 2020;16(1):35. https://doi.org/10.1186/s13005-020-00249-9
4. Khominets V.V., Vorobev K.A., Sokolova M.O., Ivanova A.K., Komarov A.V. Allogeneic osteoplastic materials for reconstructive surgery of combat injuries. Russian Military Medical Academy Reports. 2022;41(3):309–314. (In Russ.) https://doi.org/10.17816/rmmar109090
5. Athanasiou V.T., Papachristou D.J., Panagopoulos A., Saridis A., Scopa C.D., Megas P. Histological comparison of autograft, allograftDBM, xenograft, and synthetic grafts in a trabecular bone defect: an experimental study in rabbits. Med. Sci. Monit. 2010;16(1):BR24–31. PMID: 20037482.
6. Galia C.R., Lourenço A.L., Rosito R., Souza Macedo C.A., Camargo L.M. Physicochemical characterization of lyophilized bovine bone grafts. Rev. Bras. Ortop. 2015;46(4):444–451. https://doi.org/10.1016/S2255-4971(15)30260-3
7. Hench L.L., Jones J.R.. Bioactive Glasses: Frontiers and Challenges. Front. Bioeng. Biotechnol. 2015;3:194. https://doi.org/10.3389/fbioe.2015.00194
8. Charchyan E.R., Stepanenko A.B., Galeev N.A., Khovrin V.V., Kim M.G. Method of determining the degree of healing of the sternum during its fixation after cardiac surgery with complete median sternotomy. Patent RU 2647796 C1. Date of registration: 19.03.2018. eLibrary ID: 37366106, EDN: KTMGZH.
9. Balachandran S., Sorohan M., Denehy L., Lee A., Royse A., Royse C. et al. Is ultrasound a reliable and precise measure of sternal micromotion in acute patients after cardiac surgery? Int. J. Ther. Rehabil. 2017;24(2):62– 70. https://doi.org/10.12968/ijtr.2017.24.2.62
10. Royse A.G., El-Ansary D., Hoang W., Lui E., McCusker M., Tivendale L. et al. Cite this article as A randomized trial comparing the effects of sternal band and plate fixation of the sternum with that of figure-of-8 wires on sternal edge motion and quality of recovery after cardiac surgery. Interact. CardioVasc. Thorac. Surg. 2020;30(6):863– 870. https://doi.org/10.1093/icvts/ivaa040
11. El-Ansary D., Balachandran S., Royse A., King-Shier K., Bryant A., Denehy L. et al. Real-time ultrasound assessment of sternal stability in adhesive-enhanced sternal closure. J. Transl. Sci. 2015;1(3):65–68. https://doi.org/10.15761/JTS.1000115
12. Bazikyan E.A. Modern osteoplastic materials. Moscow: GEOTAR-Media, 2018:96. (In Russ.) ISBN 978-5-9704-4582-2.
13. Kozlov B.N., Kuznetsov M.S., Alexandrova E.A., Nasrashvili G.G., Panfilov D.S., Sonduev E.L. Method for preventing non-infectious complications of sternum bone tissue during cardiovascular interventions. Patent RU 2743811 C1. Date of registration: 21.07.2021. URL: https://patents.s3.yandex.net/RU2743811C1_20210226.pdf (03.02.2025).
Review
For citations:
Kuznetsov M.S., Akhmedov Sh.D., Shipulin V.V., Alyamkin V.E., Bukhovets I.L., Gusakova A.M., Afanasyeva N.L., Kozlov B.N. Use of bone chips to improve sternum bone tissue regeneration after median sternotomy in patients with a high risk of sternal dehiscence in cardiac surgery (case report). Siberian Journal of Clinical and Experimental Medicine. 2025;40(2):142-149. (In Russ.) https://doi.org/10.29001/2073-8552-2025-40-2-142-149