| Placement of trans-sternal wires according to an ellipsoid pressure vessel model of sternal forces. | |
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MedLine Citation:
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PMID: 22186126 Owner: NLM Status: Publisher |
Abstract/OtherAbstract:
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Dehiscence of median sternotomy wounds remains a clinical problem. Wall forces in thin-walled pressure vessels can be calculated by membrane stress theory. An ellipsoid pressure vessel model of sternal forces is presented together with its application for optimal wire placement in the sternum. Sternal forces were calculated by computational simulation using an ellipsoid chest wall model. Sternal forces were correlated with different sternal thicknesses and radio-density as measured by computerized tomography (CT) scans of the sternum. A comparison of alternative placement of trans-sternal wires located either at the levels of the costal cartilages or the intercostal spaces was made. The ellipsoid pressure vessel model shows that higher levels of stress are operative at increasing chest diameter (P < 0.001). CT scans show that the thickness of the sternal body is on average 3 mm and 30% thicker (P < 0.001) and 53% more radio-dense (P < 0.001) at the costal cartilage levels when compared with adjacent intercostal spaces. This results in a decrease of average sternal stress from 438 kPa at the intercostal space level to 338 kPa at the costal cartilage level (P = 0.003). Biomechanical modelling suggests that placement of trans-sternal wires at the thicker bone and more radio-dense level of the costal cartilages will result in reduced stress. |
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Authors:
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Aaron R Casha; Alex Manché; Marilyn Gauci; Marie-Therese Camilleri-Podesta; Pierre Schembri-Wismayer; Zdenka Sant; Ruben Gatt; Joseph N Grima |
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Publication Detail:
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Type: JOURNAL ARTICLE Date: 2011-12-20 |
Journal Detail:
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Title: Interactive cardiovascular and thoracic surgery Volume: - ISSN: 1569-9285 ISO Abbreviation: - Publication Date: 2011 Dec |
Date Detail:
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Created Date: 2011-12-21 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 101158399 Medline TA: Interact Cardiovasc Thorac Surg Country: - |
Other Details:
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Languages: ENG Pagination: - Citation Subset: - |
Affiliation:
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Department of Cardiothoracic Surgery, Mater Dei Hospital, Msida, Malta. |
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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