How is the sternum usually closed after a cardiac surgery?

The sternum is typically closed after cardiac surgery using metal wire sutures. This method is preferred because it provides the necessary strength and stability to hold the bony fragments of the sternum securely together as they heal. The use of stainless steel wire or heavy gauge suture material allows for a secure approximation of the sternum, preventing any separation that could occur during the healing process or with postoperative activities.

Metal wire sutures are particularly advantageous due to their durability and their ability to withstand movement and stress during recovery, which is crucial as the sternum can undergo significant forces from respiratory movements and other activities. This approach minimizes the risk of complications such as sternal dehiscence, which can happen if the sternum isn't securely closed.

While absorbable sutures, adhesive compounds, and staples have their own specific applications in various surgical contexts, they do not offer the same level of strength and long-term support that is essential in thoracic surgeries. This makes metal wire sutures the standard choice for sternal closure in cardiac procedures.