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A new cable-tie based sternal closure system: description of the device, technique of implantation and first clinical evaluation

Martin TR Grapow*, Ludovic F Melly, Friedrich S Eckstein and Oliver T Reuthebuch

  • * Corresponding author: Martin TR Grapow

  • † Equal contributors

Author Affiliations

Department of Cardiac Surgery, University Hospital Basel, Spitalstrasse 21, CH-4031, Basel, Switzerland

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Journal of Cardiothoracic Surgery 2012, 7:59  doi:10.1186/1749-8090-7-59

Published: 25 June 2012



Wire closure still remains the preferred technique despite reasonable disadvantages. Associated complications, such as infection and sternal instability, cause time- and cost-consuming therapies. We present a new tool for sternal closure with its first clinical experience and results.


The sternal ZipFixTM System is based on the cable-tie principle. It primarily consists of biocompatible Poly-Ether-Ether-Ketone implants and is predominantly used peristernally through the intercostal space. The system provides a large implant-to-bone contact for better force distribution and for avoiding bone cut through.


50 patients were closed with the ZipFixTM system. No sternal instability was observed at 30 days. Two patients developed a mediastinitis that necessitated the removal of the device; however, the ZipFixTM were intact and the sternum remained stable.


In our initial evaluation, the short-term results have shown that the sternal ZipFixTM can be used safely and effectively. It is fast, easy to use and serves as a potential alternative for traditional wire closure.

Cable-tie; PEEK; Sternal closure