Sternal wires are a common component of recovery after open-heart surgery. They play a specific role in healing the breastbone, which is divided for surgery. Understanding their function and long-term implications helps patients.
The Role and Permanence of Sternal Wires
Sternal wires are thin, medical-grade wires, typically made of stainless steel or titanium, used to secure the breastbone (sternum) after it is opened during a median sternotomy. This surgical incision allows surgeons access to the heart. After the cardiac procedure, the sternum halves are realigned and bound together with these twisted wires, which hold the bone fragments tightly like a splint, allowing proper healing.
Most sternal wires remain in the body permanently. This design provides long-term stability for sternal healing and fusion. While the sternum typically regains about 90% of its strength within 8 to 10 weeks, the wires continue to offer support. Removing them would require another surgical procedure, introducing risks like infection, bleeding, or tissue damage. Therefore, leaving these well-tolerated, inert wires in place is generally safer and more practical for most patients.
When Sternal Wires Are Removed
While sternal wires are typically permanent, specific medical circumstances may necessitate their removal. The most frequent reason is an infection at the surgical site. Infections can cause persistent pain, redness, swelling, or drainage, and wire removal can be part of the treatment to clear the infection.
Another reason for removal is chronic pain linked to the wires. This pain might occur if a wire becomes loose, migrates, or irritates surrounding tissues or nerves. Wire breakage, though rare, can also lead to sharp ends irritating the skin or deeper tissues, prompting removal. In some instances, if the sternum fails to heal properly (sternal non-union), wires might be removed as part of a revision surgery to re-stabilize the breastbone, sometimes with plates and screws.
Living with Sternal Wires
For most individuals, living with sternal wires involves minimal implications after initial healing. The wires are designed to be inert within the body; they do not react with biological tissues or interfere with daily activities. Patients can typically return to their normal routines, including physical exercise, once cleared by their medical team.
Sternal wires made of stainless steel or titanium are generally safe for Magnetic Resonance Imaging (MRI). These materials are non-ferromagnetic or minimally paramagnetic, so they are not significantly affected by MRI magnetic fields. However, it is important to inform medical technicians about the wires before any imaging procedure. Similarly, sternal wires usually do not trigger airport metal detectors, but carrying a medical identification card can be helpful for reassurance if a detector is activated.