A New Proposal of Skin-Closure System for Median Sternotomy: Usefulness and Cosmetic Results Analysis of Medizip™ Surgical Zipper in Neoplastic Immuno-Compromised Patients

Background and Objectives: The authors evaluate the effectiveness and the cosmetic results obtained using the new skin closing system MEDIZIP ^TM Surgical Zipper in oncological immuno-compromised patients submitted to median sternotomy. Methods: In our Institute, from 1999 to 2002, MEDIZIP^TM was used to close the sternal wounds in 45 patients undergoing median sternotomy for bilateral metastasectomy. It took about half a minute (mean time: 32.00 ± 11.48 sec) to perform the application. To evaluate the cosmetic results, a three-level scale was conceived: level 1: very good, level 2: satisfactory, level 3: inadequate. Results: Overall forty-two 20 cm-long zippers were used, two 25 cm-long and one 30 cm-long. MEDIZIP ^TM remained in situ for an average of 9.98 ± 2.23 days (median: 9 days; range: 8-13 days). The average time taken for inspection was 70.00 ± 2.48 sec (median: 70, range: 45 - 130) and the zipper was removed in a few seconds. No wound infections were observed. We classified 39 patients at level 1 (very good, 87%), and 6 at level 2 (satisfactory, 13%). Conclusions: MEDIZIP^TM can be considered an effective skin-closure system which is easily and quickly handled and assures good cosmetic results with non-invasive removal; it proves particularly useful in pediatric patients and in adults affected by neoplastic diseases and undergoing multiple combined anti-cancer treatments.