胸骨離開を予防するための新規デバイスの140例の使用経験

Usage of New Device to Prevent Sternum Separation after Median Sternotomy in 140 Cases

近年，心臓血管外科手術において，低侵襲心臓手術（MICS）が普及しているが，MICSでは対応できない症例やMICSを行っていない施設では，胸部正中切開手術によるアプローチが一般的である．胸骨正中切開による合併症に縦隔炎があるが，その予防は重要である．特に周術期の胸骨動揺は縦隔炎の誘因となるため1），胸骨離開を予防することが非常に大切である．2018年8月ごろより登場した波板状の骨接合材（Super Fixsorb Wave）［帝人メディカルテクノロジー社，大阪］（以下，Wave）を周術期の胸骨離開の予防のために使用した1年半あまりの経験を報告する．

While minimally invasive cardiac surgery （MICS） has become increasingly popular recently even in the field of cardiovascular surgery, the conventional full median sternotomy is still the main approach to the mediastinum, especially for cases which cannot be applied for MICS or in the facilities where MICS is not performed. It has been known that sternal instability is one of the leading causes of sternal infection after median sternotomy. Therefore, we have sought for an additional product to secure strong sternal stability. Since August in 2018, we used a new type of corrugated plate （Super Fixsorb Wave） which is placed inside the sternum in addition to regular sternal wires for 140 patients who had full median sternotomy. Up to now, we have no complications regarding sternotomy including mediastinitis. We believe that additional use of Super Fixsorb Wave enables firm sternal stability and prevents mediastinitis following full median sternotomy.