Ann Thorac Surg 2002;74:745
© 2002 The Society of Thoracic Surgeons
Invited commentary
David J. Cohen, MDa
a Colonel, Medical Corps, Brooke Army Medical Center MCHE-SDC, Cardiothoracic Surgery Service, 3851 Roger Brooke Drive, Bldg 3600, Fort Sam Houston, TX 78234-6200, USA
e-mail: david.cohen{at}cen.amedd.army.mil
Expense, limited availability, and biological variability complicate the use of cadaver specimens for testing mechanical methods of sternal closure. The use of artificial polyurethane models has been common in the development and testing of orthopedic appliances. A simple polyurethane sternal model that stimulates cancellous or medullary bone has been developed for the testing of sternal closure techniques. More complex composite models, which mimic cortical bone applied to a medullary bony core, can be created, but they are more expensive and may provide little advantage.
The tests conducted in this study demonstrate a high level of consistency between the simple medullary sternal model and cadaver specimens. This study is very important in that it validates a simple and inexpensive method of testing a wide array of appliances, as well as other techniques of sternal closure. The validation of these models makes it cost effective to test sternal closure methods under a wide variety of conditions using the various destructive methods common in materials testing. Development of better methods of sternal closure will reduce the extreme disability and expense associated with sternal dehiscence.
