Persistent chest wall pain due to sternal wire sutures after median sternotomy. How effective is sternal wire removal?

Objective: One of the most underestimated complications following heart surgery, through median sternotomy, is a persistent anterior thoracic pain due to sternal wire. We report our 13 years experience with complete sternal wire removal.

Methods: Between April 1995 and May 2009, 165 patients received sternal wire removal. Patients with myocardial ischemia, wound infection, sternal instability were excluded. The patients were interviewed about the outcome after wire removal.

Results: Complete follow-up was possible by 154 patients (93%) since 11 patients were lost of follow-up (7%). Mean age was 64, 8 years and the vast majority male (129/165, 77, 8%). Mean operation time was 28, 3 minutes. Wire removal was performed 18 months (4–156 months) after the primary procedure. The most of the patients (143/165, 87%) received CABG and only 11 patients of them (8%) did not have an IMA graft. In two cases (2/126, 1, 6%) a sternal wound infection postoperative made local wound treatment necessary. By all other patients wound healing was uneventful. The majority of the patients followed up (145/154, 94, 2%) reported relief of symptoms, while only 9 patients (5, 8%) reported no change or worsening of the pain after wire removal.

Conclusions: Surgical removal of sternal wire sutures is a very simple and effective procedure. Removal of all wires relieved pain by the majority of patients. Sternal wire removal should be offered to patients with foreign material related persistent anterior chest wall pain after sternotomy, when other serious postoperative complications have been excluded.