Thermoreactive clips do not reduce sternal infection: a propensity-matched comparison with sternal wires.OBJECTIVES
 This paper examines whether nitinol thermoreactive clips reduce sternal wound infection rates in obese patients [body mass index (BMI) ≥30] compared with sternal wires.


 All patients with BMI ≥30 undergoing cardiac surgery via median sternotomy between February 2008 and February 2013 in our institution were divided into two groups depending on sternal closure technique-sternal wires or thermoreactive clips.  Of 1371 patients, 826 (60%) had thermoreactive clips and 545 (40%) sternal wires.  In unmatched group comparison, both superficial sternal wound infection (thermoreactive clips 4% vs wires 3%) and deep infection (thermoreactive clips 3% vs wires 0.6%, P = 0.00) were more common in the thermoreactive clips group.  More patients in the thermoreactive clips group required debridement and a larger number had vacuum-assisted closure [thermoreactive clips 10 patients (1%) vs sternal wires 2 (0.4%)].  There was no difference in sternal wound infection rates [thermoreactive clips 19 patients (5%) vs sternal wires 15 (4%), P = 0.58] or deep sternal infection rates [thermoreactive clips 9 patients (3%) vs sternal wires 3 (1%), P = 0.11].


 Thermoreactive clips did not have an advantage in the prevention of superficial or deep sternal wound infection in obese patients undergoing sternotomy.
THERM