A new cable-tie based sternal closure system: description of the device, technique of implantation and first clinical evaluation

Background: Wire closure still remains the preferred technique despite reasonable disadvantages. Associated complications, such as infection and sternal instability, cause time- and cost-consuming therapies. We present a new tool for sternal closure with its first clinical experience and results. Methods: The sternal ZipFix (TM) System is based on the cable-tie principle. It primarily consists of biocompatible Poly-Ether-Ether-Ketone implants and is predominantly used peristernally through the intercostal space. The system provides a large implant-to-bone contact for better force distribution and for avoiding bone cut through. Results: 50 patients were closed with the ZipFix (TM) system. No sternal instability was observed at 30 days. Two patients developed a mediastinitis that necessitated the removal of the device; however, the ZipFix (TM) were intact and the sternum remained stable. Conclusions: In our initial evaluation, the short-term results have shown that the sternal ZipFix (TM) can be used safely and effectively. It is fast, easy to use and serves as a potential alternative for traditional wire closure.