Sternum fissure closure and repair

The sternal fissure can be repaired by direct suture or directly sutured with costal cartilage and rib arch repair, and no artificial materials are needed. It is best to repair in the neonatal period. At this time, the thoracic tissue is elastic and easy to pull and suture. Treatment of diseases: sternal fissure Indication There is a partial or complete rupture of the sternum after birth. Infants within 1 month can be sutured directly. Contraindications Combined with other children with congenital heart disease There are other diseases that are not suitable for surgery. Preoperative preparation (1) Echocardiography to determine whether there is congenital heart disease. (2) Those with respiratory infections should be given antibiotic control. Surgical procedure (1) Longitudinal incision along the sternum, incision of the skin, subcutaneous, separation of the flap to the sternal branch of both sides of the sternal fissure; deep separation of the intrathoracic fascia, pericardium. At the same time, the wedge-shaped part of the sternum of the bifurcation is cut off to make the sternum fissure easy to fit. (2) Subperiosteal rib cartilage: In larger infants or children, due to poor chest elasticity and plasticity, part of the costal cartilage is cut under the periosteum, and the sternal fissure is easier to suture. Transplantation of autologous costal cartilage or rib arch at the sternal fissure, suitable for wedge-shaped osteotomy at the sternal bifurcation. The sternal fissure is still not directly matched. The autogenous part of the costal cartilage is removed, longitudinally opened, and implanted into the sternal fissure. . It can also remove the medial edge of the sternal branch on both sides of the sternal fissure or remove the periosteum to create a new wound margin, which is beneficial to the healing of the sternal fissure.

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