METHOD FOR STERNUM WOUND CLOSURE AFTER STERNOTOMY Russian patent published in 2020 - IPC A61B17/56 

FIELD: medicine.

SUBSTANCE: invention refers to medicine, namely to surgery, and can be used for suture repair after sternotomy. Surgical intervention on the thoracic organs is performed through a sternotomy wound. After sternotomy and performing surgical intervention on chest organs, the sternum is closed with eight U-sutures of steel wire. At the end of the operation, the subcutaneous fat is sutured with a continuous suture and then the skin. Suturing is started from the sternum wound, extending 1.5–2.0 cm from the right side; the steel wire is passed backwards through a fascia-muscular layer, an aponeurosis, a sternum handle with a prick out on the back surface of the sternum handle. Then, from the point of sticking out at 2.0–2.5 cm downwards and parallel to the wound line, the steel wire is passed behind in advance through the sternum, aponeurosis, fascia-muscular layer with a prick out on the anterior surface of the sternum handle. Further, on the opposite side of the sternum wound, extending from left edge 1.5–2.0 cm, the steel wire is passed backwards through a fascia-muscular layer, an aponeurosis, a sternum handle with a prick out on the back surface of the sternum handle. Then, stepped from the point of stick-out by 2.0–2.5 cm upwards and parallel to the wound line, the steel wire is carried forward from behind through the sternum, aponeurosis, fascia-muscular layer with a needle prick on the anterior surface of the sternum handle. Ends of steel wire of the first suture are fixed by twisting along the middle line after all sutures are applied. Retreating 1.5–2.0 cm from the first suture downward, applying a second U-shaped suture at 1.5–2.0 cm from the right side of the sternal wound, performing a steel wire from the front backwards through a fascia-muscular layer, an aponeurosis, a sternum with sticking out on posterior surface of sternum. Then, steel wire is passed to opposite side of sternal wound at 1.5–2.0 cm from left edge of sternal wound, steel wire is passed behind in front through sternum, aponeurosis, fascicle-muscular layer with sticking out on front surface of sternum. Further, from the point of sticking out at 2.0–2.5 cm down and parallel to the wound line, the steel wire is passed backwards through a fascia-muscular layer, an aponeurosis, a sternum with a sticking out on the posterior surface of the sternum. Then, steel wire is passed to opposite side of sternal wound at 1.5–2.0 cm from right side of sternal wound; steel wire is delivered from behind in front through sternum, aponeurosis, fascia-muscular layer with sticking out on front surface of sternum. Ends of steel wire of second suture are fixed by twisting on right side of sternum after application of all sutures. Then lower subsequent sutures are applied, third, fifth, seventh is applied similarly to first suture, fourth, sixth, eighth are applied similarly to second suture. U-shaped sutures are bonded after all sutures are applied.

EFFECT: method provides additional strength and prevents destruction of bone tissue by suturing through the aponeurosis and the fascial-muscular layer.

1 cl, 2 dwg, 1 ex