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Pilot et al: Comparison of median sternotomy closure‐related complication rates using orthopedic wire or suture in dogs: A multi-institutional observational treatment effect analysis
Veterinary Surgery 6, 2022

🔍 Key Findings

  • Overall closure-related complication rate was 14.1%, lower than previously reported (17–78%).
  • No clinically meaningful difference in complication rate between orthopedic wire (17.4%) and suture (11.5%) closure methods.
  • Dog size (≥20 kg) was the only significant risk factor associated with increased closure-related complications (p = .01).
  • Type of closure (wire vs. suture) did not affect risk, even in larger dogs.
  • Suture closure showed a non-significant trend toward fewer complications (mean reduction 2.3%, 95% CI: –9.1% to +4.5%).
  • Most complications were mild (62%), with only 10 severe cases requiring surgical revision.
  • Infection rate was low (2.7%), and not significantly different between wire and suture.
  • Suture closure is a valid alternative to wire, including in large dogs, based on this large, multi-institutional study.

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← Articles

Pilot et al: Comparison of median sternotomy closure‐related complication rates using orthopedic wire or suture in dogs: A multi-institutional observational treatment effect analysis
Veterinary Surgery 6, 2022

🔍 Key Findings

  • Overall closure-related complication rate was 14.1%, lower than previously reported (17–78%).
  • No clinically meaningful difference in complication rate between orthopedic wire (17.4%) and suture (11.5%) closure methods.
  • Dog size (≥20 kg) was the only significant risk factor associated with increased closure-related complications (p = .01).
  • Type of closure (wire vs. suture) did not affect risk, even in larger dogs.
  • Suture closure showed a non-significant trend toward fewer complications (mean reduction 2.3%, 95% CI: –9.1% to +4.5%).
  • Most complications were mild (62%), with only 10 severe cases requiring surgical revision.
  • Infection rate was low (2.7%), and not significantly different between wire and suture.
  • Suture closure is a valid alternative to wire, including in large dogs, based on this large, multi-institutional study.

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Multiple Choice Questions on this study

In Pilot 2022 et al., on closure methods in sternotomy, how did complication severity generally present?

A. Mostly severe complications
B. Equal number of mild and severe
C. Mostly mild complications
D. Only surgical infections were reported
E. Majority required surgical revision

Answer: Mostly mild complications

Explanation: Of the 37 complications, most were mild (62%), with only 10 severe cases.
In Pilot 2022 et al., on closure methods in sternotomy, what was concluded regarding closure technique choice in large dogs?

A. Sutures are contraindicated in large dogs
B. Wires reduce risk in dogs ≥20 kg
C. Closure material choice does not affect risk in large dogs
D. Sutures increase risk of fracture in large dogs
E. Sternal healing is faster with wires

Answer: Closure material choice does not affect risk in large dogs

Explanation: Dog size increased risk of complications, but closure method did not alter this risk.
In Pilot 2022 et al., on closure methods in sternotomy, what was the observed difference in complication rates between wire and suture groups?

A. Complication rates were 5% higher with suture
B. Complication rates were 5% higher with wire
C. Suture was associated with a 2.3% lower complication rate
D. Wire was associated with a 2.3% lower complication rate
E. No difference was observed

Answer: Suture was associated with a 2.3% lower complication rate

Explanation: Treatment effect analysis showed a mean 2.3% lower complication rate with suture, though not statistically significant.
In Pilot 2022 et al., on closure methods in sternotomy, what was the overall rate of closure-related complications observed in dogs?

A. 5.1%
B. 9.4%
C. 14.1%
D. 17.8%
E. 22.3%

Answer: 14.1%

Explanation: This multi-institutional study found a 14.1% complication rate after median sternotomy closure.
In Pilot 2022 et al., on closure methods in sternotomy, which of the following was significantly associated with an increased risk of complications?

A. Closure material used
B. Surgeon experience
C. Dog size
D. Age of dog
E. Type of surgery

Answer: Dog size

Explanation: In multivariable regression, only dog size (≥20 kg) was significantly associated with increased complication risk.

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