Параклинические методы исследования репаративной регенерации грудины после холодноплазменной и стандартной стернотомии

Objective of the study was to evaluate the course of uncomplicated reparative sternum regeneration after median sternotomy performed in two different methods as well as after injury complications of the sternal wall using a number of paraclinic examinations.Materials for the analysis were examination data from 50 patients who underwent CABG performed through median sternotomy. The patients were divided into three groups: first group were the patients in whom sternomy was performed using sternal saw with cold-plasma tip; the control group patients were those with standard sternotomy using electrocoagulation and medical wax for hemostasis; a separate group – group two were the patients with injury complications on the anterior sternal wall after sternotomy. At different stages of the treatment apart from the routine protocol procedures adopted at our department, enzyme immunoassay for the identification of bone metabolism markers in blood (osteocalcin, bone alkaline phoaphatase) and urine (deoxypyridinoline) had been carried out three times as well as spiral CT and sternal bone scanning.The study has revealed high intensity osteoblastic processes taking place in the patients of the first group with significant reduction of resorption and decline of inflammatory processes in the mid-term period. The least intensity of the regenerative process has been noticed in the group of patients with complications (group 2).Sternotomy performed with the sternal saw with cold-plasma tip makes less traumatic effect on the sternal tissues; it reduces the time and severity of inflammation at the site of surgical approach. Thus, it may contribute to the lower incidence of injury complications after sternotomy.