{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,29]],"date-time":"2026-05-29T23:51:21Z","timestamp":1780098681529,"version":"3.54.0"},"reference-count":0,"publisher":"Georg Thieme Verlag KG","issue":"06","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Thorac cardiovasc Surg"],"published-print":{"date-parts":[[2018,9]]},"abstract":"<jats:p>\n            Background\u2003Median sternotomy in patients with risk factors for wound healing is associated with high rates of postoperative wound infections and sternum instability.<\/jats:p><jats:p>\n            Methods\u2003A total of 338 patients with elective first median sternotomy and at least four predefined risk factors were randomized between Sternal Talon (Gebr\u00fcder Martin GmbH &amp; Co. KG\u2014KLS Martin Group, Tuttlingen, Germany) and wire cerclage. The primary end point was mediastinitis and\/or sternal instability within 30\u2009\u00b1\u20095 days, and the secondary end points were mediastinitis and\/or sternal instability within 60\u2009\u00b1\u20095 days; incidence of pneumonia during hospitalization within the first 30 (\u00b15) days and chest pain intensity.<\/jats:p><jats:p>\n            Results\u2003The primary end point was reached in 10 Sternal Talon and 7 wire cerclage patients (6.2 vs. 4.7%, odds ratio [OR]: 1.3, 95% confidence interval [CI]: 0.5\u20133.6, p\u2009=\u20090.57) from 338 randomized patients. Sternal Talon group, n\u2009=\u2009170 patients versus wire cerclage group, n\u2009=\u2009168 patients. The differences between treatment groups with regard to the incidence of mediastinitis\/sternum instability within the first 60 (\u00b15) days after the primary sternum closure and the incidence of pneumonia during the hospitalization within the first 30 (\u00b15) days were not statistically significant, either. We observed comparable rates of superficial surgical site infection (SSI) in Sternal Talon and wire cerclage patients (16.1 vs. 12.1%, OR: 1.4, 95% CI: 0.7\u20132.7, p\u2009=\u20090.31).<\/jats:p><jats:p>\n            Conclusion\u2003According to these data, there is no statistically significant difference between Sternal Talon closure and wire cerclage in reducing the incidence of mediastinitis and superficial SSI after primary closure of median sternotomy in high-risk patients.<\/jats:p>","DOI":"10.1055\/s-0037-1618584","type":"journal-article","created":{"date-parts":[[2018,2,3]],"date-time":"2018-02-03T10:24:46Z","timestamp":1517653486000},"page":"508-516","source":"Crossref","is-referenced-by-count":4,"title":["The COSTA Study: Sternal Closure in High-Risk Patients - A Prospective Randomized Multicenter Trial"],"prefix":"10.1055","volume":"66","author":[{"given":"Claudia","family":"Heilmann","sequence":"first","affiliation":[{"name":"Saxon University of Cooperative Education, Plauen, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stefan","family":"Sorg","sequence":"first","affiliation":[{"name":"Department of Cardiovascular Surgery, Heart Center, University of Freiburg, Freiburg, Germany"},{"name":"Faculty of Medicine, University of Freiburg, Freiburg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matthias","family":"Mueller","sequence":"first","affiliation":[{"name":"Department of Cardiovascular Surgery, Heart Center, University of Freiburg, Freiburg, Germany"},{"name":"Faculty of Medicine, University of Freiburg, Freiburg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sami","family":"Kueri","sequence":"first","affiliation":[{"name":"Department of Cardiovascular Surgery, Heart Center, University of Freiburg, Freiburg, Germany"},{"name":"Faculty of Medicine, University of Freiburg, Freiburg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Claudia","family":"Schmoor","sequence":"first","affiliation":[{"name":"Faculty of Medicine, University of Freiburg, Freiburg, Germany"},{"name":"Clinical Trials Unit, Faculty of Medicine and Medical Center, University of Freiburg, Freiburg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matthias","family":"Siepe","sequence":"first","affiliation":[{"name":"Department of Cardiovascular Surgery, Heart Center, University of Freiburg, Freiburg, Germany"},{"name":"Faculty of Medicine, University of Freiburg, Freiburg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Friedhelm","family":"Beyersdorf","sequence":"first","affiliation":[{"name":"Department of Cardiovascular Surgery, Heart Center, University of Freiburg, Freiburg, Germany"},{"name":"Faculty of Medicine, University of Freiburg, Freiburg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tetyana","family":"Leinberger","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Surgery, Heart Center, University of Freiburg, Freiburg, Germany"},{"name":"Faculty of Medicine, University of Freiburg, Freiburg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"194","published-online":{"date-parts":[[2018,2,2]]},"container-title":["The Thoracic and Cardiovascular Surgeon"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/www.thieme-connect.de\/products\/ejournals\/pdf\/10.1055\/s-0037-1618584.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2018,9,4]],"date-time":"2018-09-04T22:33:40Z","timestamp":1536100420000},"score":1,"resource":{"primary":{"URL":"http:\/\/www.thieme-connect.de\/DOI\/DOI?10.1055\/s-0037-1618584"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2018,2,2]]},"references-count":0,"journal-issue":{"issue":"06","published-online":{"date-parts":[[2018,9,4]]},"published-print":{"date-parts":[[2018,9]]}},"URL":"https:\/\/doi.org\/10.1055\/s-0037-1618584","relation":{},"ISSN":["0171-6425","1439-1902"],"issn-type":[{"value":"0171-6425","type":"print"},{"value":"1439-1902","type":"electronic"}],"subject":[],"published":{"date-parts":[[2018,2,2]]}}}