METHOD FOR SURGICAL MANAGEMENT OF POSTOPERATIVE STERNOMEDIASTINITIS Russian patent published in 2016 - IPC A61B17/00 

FIELD: medicine.

SUBSTANCE: method involves using retainers made of an intermetallic titanium nickelide material or a material of copper - 14 wt %, aluminium - 4 wt %, nickel system having a bending resistance falling within the range of 25-85 N/mm and an elasticity modulus of 15-20 hPa; the materials are cooled down to a point that is below a reverse phase martensite transformation temperature. A homeostasis is performed by means of diathermy. A titanium alloy BT 1-00 or BT-16 wire net of monofilament or polyfilament titanium threads 50-140 mcm in diameter covers as an implant, a patient's anterior thoracic wall from the suprasternal notch to 4^th intercostals space; the titanium mesh implant is fixed in the centre by means of sternum retainers overlaying it by 38-42 mm from each side from the sternum mid-line up to cartilage segments of the ribs. Then, after the titanium mesh implant is pre-fixed angularly by means of a Prolene 2/0 blanket suture, it is tightly fixed unstrained along the perimeter to the anterior thoracic wall, namely to the perichondrium, intercostal muscles and periosteum by means of a continuous suture; the titanium mesh implant is additionally fixed along the surface area by means of single Prolene 2/0 interrupted sutures spaced at 20-23 mm, to the anterior thoracic wall. Flaps of greater pectoral muscles are fixed in layers to the bottom of the wound and to the titanium mesh implant by single Vicryl 2/0 absorbent interrupted sutures. The muscles are sutured by single interrupted stitches, and subcutaneous fat and skin are sutured by continuous stitches.

EFFECT: method enables the reliable sternum fixation, good cosmetic effect, and conditions for early rehabilitation.

3 cl