Sternal Closure With SternaLock 360: First in Man Study

NCT ID: NCT02686099

Last Updated: 2018-01-18

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

NA

Total Enrollment

50 participants

Study Classification

INTERVENTIONAL

Study Start Date

2015-07-04

Study Completion Date

2018-01-15

Brief Summary

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The SternaLock 360 Sternal Closure Device combines the techniques of rigid fixation with a cerclage material into a single sternal closure system. The cerclage material serves to facilitate sternal approximation, and the plates and screws serve to provide rigid fixation and prevent sternal movement and separation. The combination of a cerclage material in combination with plate and screw fixation may also lead to increased stability compared to either method used as a standalone means of closure.

Detailed Description

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The purpose of this study is to evaluate a new technology for sternal closure that combines rigid plate fixation with a cerclage material in patients undergoing a cardiac surgery subsequent to a full median sternotomy. This study will evaluate intraoperative outcomes related to the surgical technique and performance of the device, sternal healing and stability, sternal wound complications and postoperative recovery (e.g. pain and functional status) in patients closed with this device. For comparative purposes, a control group of wire cerclage patients will be included.

Conditions

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Sternal Fracture

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Comparison of intervention using sternal closure with 360 plating system, to closure of the sternum using wire cerclage
Primary Study Purpose

TREATMENT

Blinding Strategy

SINGLE

Participants
participants are blinded to treatment choice until completion of the study.

Study Groups

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SternaLock 360

Sternal closure performed with SternaLock 360 as a primary closure system

Group Type EXPERIMENTAL

SternaLock 360

Intervention Type DEVICE

Sternal closure with SternaLock 360

Wire Cerclage

Sternal closure performed with standard wire cerclage as a primary closure system

Group Type ACTIVE_COMPARATOR

Wire Cerclage

Intervention Type DEVICE

Sternal closure with standard wire cerclage

Interventions

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SternaLock 360

Sternal closure with SternaLock 360

Intervention Type DEVICE

Wire Cerclage

Sternal closure with standard wire cerclage

Intervention Type DEVICE

Eligibility Criteria

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Inclusion Criteria

* Patients undergoing a standard midline sternotomy as a result of a cardiac surgical procedure (i.e. coronary artery bypass graft (CABG) and/or valve replacement along with other cardiac surgical procedures)
* Patients ≥ 30 years of age
* Patients who sign the Informed Consent

Exclusion Criteria

* Patients with endstage renal failure who are on dialysis or post transplant patients
* Patients taking chronic (\>30 days) pre-operative narcotics
* Patients taking chronic (\>30 days) steroids, immunosuppressant (including biologic immunosuppressants such as Enbrel), or chemotherapeutics (e.g. methotrexate). Patients using a steroid inhaler for asthma should not be excluded.
* Patients with confirmed HIV with a viral load of \>10,000 copies
* Patients with an active infection that is currently being treated
* Patients with history or confirmed metal allergy or foreign body sensitivity
* Patients with a previous partial or full midline sternotomy
* Patients with previous radiation treatment of the chest
* Patients defined within the New York Heart Association (NYHA) or Canadian Cardiovascular Society (CCS) functional Class IV for congestive heart failure: i.e., patients with cardiac disease resulting in inability to carry on any physical activity without discomfort (CCS ; NYHA)
* Patients presenting emergent/salvage cardiac acuity as defined per the Society of Thoracic Surgeons (STS) guidelines: i.e., patients undergoing cardiopulmonary resuscitation en route to the operating room or prior to induction of anesthesia (STS)
* Patients unwilling or unable to return for follow-up


* Patients requiring delayed sternotomy closure
* Patients with transverse sternal fractures located beneath the cerclage band on the SternaLock 360 Device.
* Patients presenting intra-operative conditions that in the opinion of the treating surgeon would require or preclude a specific method for sternal closure, or who are not able to be closed per the protocol.
* Use of non resorbable (beeswax) bonewax along the sternotomy
Minimum Eligible Age

30 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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University of Cape Town

OTHER

Sponsor Role collaborator

Zimmer Biomet

INDUSTRY

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Brian M Hatcher, PhD

Role: STUDY_DIRECTOR

Zimmer Biomet

Locations

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Groote Schuur Hospital

Cape Town, , South Africa

Site Status

Countries

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South Africa

References

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Casha AR, Yang L, Kay PH, Saleh M, Cooper GJ. A biomechanical study of median sternotomy closure techniques. Eur J Cardiothorac Surg. 1999 Mar;15(3):365-9. doi: 10.1016/s1010-7940(99)00014-7.

Reference Type BACKGROUND
PMID: 10333037 (View on PubMed)

Cohen DJ, Griffin LV. A biomechanical comparison of three sternotomy closure techniques. Ann Thorac Surg. 2002 Feb;73(2):563-8. doi: 10.1016/s0003-4975(01)03389-6.

Reference Type BACKGROUND
PMID: 11845875 (View on PubMed)

Hirose H, Yamane K, Youdelman BA, Bogar L, Diehl JT. Rigid sternal fixation improves postoperative recovery. Open Cardiovasc Med J. 2011;5:148-52. doi: 10.2174/1874192401105010148. Epub 2011 Jul 4.

Reference Type BACKGROUND
PMID: 21760857 (View on PubMed)

Lahtinen P, Kokki H, Hynynen M. Pain after cardiac surgery: a prospective cohort study of 1-year incidence and intensity. Anesthesiology. 2006 Oct;105(4):794-800. doi: 10.1097/00000542-200610000-00026.

Reference Type BACKGROUND
PMID: 17006079 (View on PubMed)

Losanoff JE, Basson MD, Gruber SA, Huff H, Hsieh FH. Single wire versus double wire loops for median sternotomy closure: experimental biomechanical study using a human cadaveric model. Ann Thorac Surg. 2007 Oct;84(4):1288-93. doi: 10.1016/j.athoracsur.2007.05.023.

Reference Type BACKGROUND
PMID: 17888985 (View on PubMed)

Losanoff JE, Collier AD, Wagner-Mann CC, Richman BW, Huff H, Hsieh Fh, Diaz-Arias A, Jones JW. Biomechanical comparison of median sternotomy closures. Ann Thorac Surg. 2004 Jan;77(1):203-9. doi: 10.1016/s0003-4975(03)01468-1.

Reference Type BACKGROUND
PMID: 14726062 (View on PubMed)

Meyerson J, Thelin S, Gordh T, Karlsten R. The incidence of chronic post-sternotomy pain after cardiac surgery--a prospective study. Acta Anaesthesiol Scand. 2001 Sep;45(8):940-4. doi: 10.1034/j.1399-6576.2001.450804.x.

Reference Type BACKGROUND
PMID: 11576043 (View on PubMed)

Pai S, Gunja NJ, Dupak EL, McMahon NL, Coburn JC, Lalikos JF, Dunn RM, Francalancia N, Pins GD, Billiar KL. A mechanical study of rigid plate configurations for sternal fixation. Ann Biomed Eng. 2007 May;35(5):808-16. doi: 10.1007/s10439-007-9272-3. Epub 2007 Mar 22.

Reference Type BACKGROUND
PMID: 17377844 (View on PubMed)

Raman J, Lehmann S, Zehr K, De Guzman BJ, Aklog L, Garrett HE, MacMahon H, Hatcher BM, Wong MS. Sternal closure with rigid plate fixation versus wire closure: a randomized controlled multicenter trial. Ann Thorac Surg. 2012 Dec;94(6):1854-61. doi: 10.1016/j.athoracsur.2012.07.085. Epub 2012 Oct 25.

Reference Type BACKGROUND
PMID: 23103010 (View on PubMed)

Raman J, Song DH, Bolotin G, Jeevanandam V. Sternal closure with titanium plate fixation--a paradigm shift in preventing mediastinitis. Interact Cardiovasc Thorac Surg. 2006 Aug;5(4):336-9. doi: 10.1510/icvts.2005.121863. Epub 2006 Apr 25.

Reference Type BACKGROUND
PMID: 17670585 (View on PubMed)

Sargent LA, Seyfer AE, Hollinger J, Hinson RM, Graeber GM. The healing sternum: a comparison of osseous healing with wire versus rigid fixation. Ann Thorac Surg. 1991 Sep;52(3):490-4. doi: 10.1016/0003-4975(91)90910-i.

Reference Type BACKGROUND
PMID: 1898136 (View on PubMed)

Schimmer C, Reents W, Berneder S, Eigel P, Sezer O, Scheld H, Sahraoui K, Gansera B, Deppert O, Rubio A, Feyrer R, Sauer C, Elert O, Leyh R. Prevention of sternal dehiscence and infection in high-risk patients: a prospective randomized multicenter trial. Ann Thorac Surg. 2008 Dec;86(6):1897-904. doi: 10.1016/j.athoracsur.2008.08.071.

Reference Type BACKGROUND
PMID: 19022005 (View on PubMed)

Song DH, Lohman RF, Renucci JD, Jeevanandam V, Raman J. Primary sternal plating in high-risk patients prevents mediastinitis. Eur J Cardiothorac Surg. 2004 Aug;26(2):367-72. doi: 10.1016/j.ejcts.2004.04.038.

Reference Type BACKGROUND
PMID: 15296898 (View on PubMed)

Related Links

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http://clinicaltrials.gov/ct2/show/study/NCT00819286?term=biomet+restore&rank=1&sect=X6015.

"Evaluation of Primary Plating in Sternotomy Patients for Osteosynthesis and Pain (RESTORE).

Other Identifiers

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0614

Identifier Type: -

Identifier Source: org_study_id

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