Rigid plate fixation versus wire cerclage for sternal closure after coronary artery bypass grafting: a retrospective cohort study.

INTRODUCTION: Sternal dehiscence remains a significant complication after coronary artery bypass grafting (CABG), particularly in high-risk patients. Evidence comparing rigid plate fixation with conventional wire cerclage is limited. AIM: To compare clinical outcomes and perioperative resource utilization between rigid plate fixation and wire cerclage for sternal closure after CABG. MATERIAL AND METHODS: This retrospective single-center cohort study included 118 patients undergoing CABG (plate fixation n = 58; wire cerclage n = 60). The primary endpoint was sternal dehiscence. Secondary outcomes included wound infection, postoperative drainage, length of stay, and 30-day mortality. RESULTS: Plate fixation was associated with significantly lower sternal dehiscence (3.4% vs. 11.6%; p = 0.04), shorter length of hospital stay (7.4 ±2.1 vs. 9.1 ±2.6 days; p = 0.02), and lower postoperative drainage volumes (p = 0.03). Among obese patients, complication rates were significantly lower with plate fixation (p < 0.05). Thirty-day mortality was similar between groups. CONCLUSIONS: Rigid plate fixation is associated with improved sternal stability and reduced morbidity, particularly among high-risk CABG patients.