Abdurrahim ÇOLAK, Süleyman Nazif ORHAN, Mehmet Hamit ÖZYAZICIOĞLU

Dört farklı sternum kapama tekniğinin etkinliğinin deneysel olarak karşılaştırılması

Amaç: Bu çalışmada çelik tel, çelik kablo, titanyum klips ve titanyum plak kullanılarak yapılan dört farklı sternum kapama yönteminin etkinliği deneysel olarak karşılaştırıldı.Çalışma planı: Yapay sternum modellerinin kullanıldığı deneylerde, modellerde yanal ayrılma, boyuna kesme ve enine kesme oluşturacak şekilde statik yüklemeler yapıldı. Yöntemler emniyet yükü (2 mm deplasmana karşılık gelen yük) ve direngenlik değerleri dikkate alınarak karşılaştırıldı. Yöntemlerin maliyetleri, uygulama kolaylıkları ve hızları da değerlendirildi.Bulgular: Yanal ayrılmada en yüksek emniyet yükü ve direngenlik değerleri titanyum klips yönteminde elde edilmesine rağmen, tüm yöntemlerin emniyet yükleri ve direngenlikleri arasındaki farklılıklar istatistiksel olarak anlamlı değildi. Boyuna kesmede, en yüksek emniyet yükü titanyum plak yönteminde elde edilmesine rağmen, emniyet yüklerinde istatistiksel anlamlılık sadece çelik kablo yöntemi ve diğer yöntemler arasında vardı. Bu yüklemede en yüksek direngenlik değeri titanyum klips yönteminde elde edilirken bu yöntemle geleneksel tel yöntemleri arasındaki farklılık istatistiksel olarak anlamlı değildi. Enine kesmede en yüksek emniyet yükü ve direngenlik değerleri titanyum klips yönteminde elde edildi ve bu yöntemle diğer yöntemler arasındaki farklılıklar istatistiksel olarak anlamlı idi. Yöntemlerin maliyetleri, uygulama kolaylıkları ve hızları dikkate alındığında, en avantajlı yöntem geleneksel çelik tel yöntemi idi.Sonuç: Deney sonuçlarımıza göre titanyum klipsler diğer yöntemlere kıyasla daha istikrarlı davranış sergiledi ve daha iyi sternal kapama sağladı.

Experimental comparison of efficiency of four different sternum closure techniques

Background: This study aims to compare experimentally the efficiency of four different sternal closure techniques performed using steel wire, steel cable, titanium clips and titanium plates. Methods: In the experiments, during which artificial sternum models were used, static loadings were performed to create lateral distraction, longitudinal shear and transverse shear in the models. The methods were compared considering their allowable load (load corresponding to 2 mm displacement) and stiffness values. The costs, and ease and speed of application of the methods were also evaluated. Results: Although the highest allowable load and stiffness values in lateral distraction were obtained in the titanium clips method, the differences in allowable load and stiffness of all methods were not statistically significant. Although the highest allowable load in longitudinal shear was obtained in the titanium plate method, the only statistical significance in allowable loads was between the steel cable method and other methods. While the highest stiffness value in this loading was obtained in the titanium clips method, the difference between this method and conventional wire methods was not statistically significant. The highest allowable load and stiffness values in transverse shear were obtained in the titanium clips method and the differences between this method and other methods were statistically significant. When the costs, and ease and speed of application of the methods were considered, the most advantageous method was the conventional steel wire method. Conclusion: According to the results of our experiments, titanium clips displayed more stable behaviour and provided better sternal closure compared to the other methods.

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