Comparison of median sternotomy closure‐related complication rates using orthopedic wire or suture in dogs: A multi‐institutional observational treatment effect analysis

Objective To determine and compare median sternotomy (MS) closure‐related complication rates using orthopedic wire or suture in dogs. Study design Multi‐institutional, retrospective observational study with treatment effect analysis. Animals 331 client‐owned dogs, of which 68 were excluded. Methods Medical records of dogs with MS were examined across nine referral centers (2004–2020). Signalment, weight, clinical presentation, surgical details, complications, and outcomes were recorded. Follow‐up was performed using patient records and email/telephone contact. Descriptive statistics, treatment effect analysis and logistic regression were performed. Results Median sternotomy closure was performed with wire in 115 dogs and suture in 148. Thirty‐seven dogs experienced closure‐related complications (14.1%), 20 in the wire group and 17 in the suture group. Twenty‐three were listed as mild, four as moderate and 10 as severe. Treatment effect analysis showed a mean of 2.3% reduction in closure‐related complications associated with using suture versus wire (95% CI: −9.1% to +4.5%). In multivariable logistic regression, the only factor associated with increased risk of closure‐related complications was dog size (p = .01). This effect was not modified by the type of closure used (interaction term: OR = 0.99 [95% CI: 0.96/1.01]). Conclusion The incidence of closure‐related complication after MS was low compared to previous reports. The likelihood of developing a closure‐related complication was equivalent between sutures and wires, independent of dog size, despite a higher proportion of complications seen in larger dogs (≥20 kg). Clinical significance Use of either orthopedic wire or suture appear to be an appropriate closure method for sternotomy in dogs of any size.