Orthopedic Principles to Facilitate Enhanced Recovery After Cardiac Surgery

Crit Care Clin. 2020 Oct;36(4):617-630. doi: 10.1016/j.ccc.2020.07.003.


Enhanced recovery after surgery (ERAS) protocols recognize early postoperative mobilization as a driver of faster postoperative recovery, return to normal activities, and improved long-term patient outcomes. For patients undergoing open cardiac surgery, an opportunity for facilitating earlier mobilization and a return to normal activity lies in the use of improved techniques to stabilize the sternal osteotomy. By following the key orthopedic principles of approximation, compression, and rigid fixation, a more nuanced approach to sternal precaution protocols is possible, which may enable earlier patient mobilization, physical rehabilitation, and recovery.

Keywords: Median sternotomy; Rigid fixation; Sternal bands; Sternal closure; Sternal fixation; Sternal plating; Sternal wiring; Wire cerclage.

Publication types

  • Review

MeSH terms

  • Bone Plates
  • Bone Wires
  • Cardiac Surgical Procedures*
  • Humans
  • Sternotomy*
  • Sternum
  • Treatment Outcome