Comparison of ZipFix and traditional wire sternal closure methods.

Sternal Closure Face-Off: ZipFix vs. Traditional Wire – Which Method Wins?

Soraya Malik in Health & Wellness August 2025 • 4 min read.

"A one-year follow-up study reveals surprising insights into pain levels, dehiscence rates, and overall patient comfort after sternotomy."

For decades, closing the sternum after open-heart surgery has relied on stainless steel wires, a method considered the gold standard due to its simplicity and low cost. However, this approach isn't without its downsides. Complications like dehiscence (separation of the sternal edges) and infections can lead to reoperations and prolonged recovery times. This has fueled the search for better solutions.

One promising alternative is the ZipFix system, a biocompatible, cable-tie-based sternal closure device made from poly-ether-ether-ketone (PEEK). ZipFix offers potential advantages like flexibility, ease of use, and strong, stable closure. But does it truly outperform traditional wires in the long run? Does it translate to tangible benefits for patients?

A recent study published in Heart, Lung and Circulation compared the outcomes of patients undergoing sternal closure with either ZipFix or conventional steel wires. Over a year-long follow-up, researchers tracked pain levels, dehiscence rates, and infection rates to determine which method truly comes out on top. This article unpacks the study's findings, revealing whether ZipFix lives up to the hype and offering valuable insights for anyone considering or facing sternal closure.

ZipFix vs. Traditional Wire: A Head-to-Head Comparison

Comparison of ZipFix and traditional wire sternal closure methods.

The study, a randomized controlled trial, involved 326 patients undergoing cardiac surgery. After the sternotomy, patients were randomly assigned to have their sternum closed with either ZipFix (168 patients) or conventional steel wires (158 patients). Researchers then meticulously followed both groups, assessing them at one, three, six, and twelve months post-discharge.

Several factors were closely monitored to compare the two methods:

Pain Severity: Measured using a visual analog scale (VAS) where patients rated their pain levels during cough.
Sternal Dehiscence: Evaluated based on clinical findings such as sternal clicking or instability during respiration or coughing.
Infections: Both incisional (superficial and deep) and organ/space infections (mediastinitis or osteomyelitis) were diagnosed according to established guidelines.

The study aimed to determine whether ZipFix could reduce pain, dehiscence, and infections compared to traditional wire closure. The results revealed some clear advantages for the ZipFix group, painting a compelling picture of its potential benefits.

The Verdict: Is ZipFix the Future of Sternal Closure?

The study's findings suggest that ZipFix offers significant advantages over conventional wire closure, particularly in reducing pain and the risk of sternal dehiscence. While infection rates were similar between the two groups, the overall benefits of ZipFix make it a compelling alternative for patients undergoing sternotomy.

Of course, this study is just one piece of the puzzle. Further research with larger sample sizes and higher-risk patients is needed to confirm these findings and explore the long-term outcomes of ZipFix closure. Cost-effectiveness is another crucial consideration, as ZipFix is currently more expensive than traditional wires.

Ultimately, the choice between ZipFix and conventional wire closure should be made on a case-by-case basis, considering the individual patient's risk factors, preferences, and the surgeon's expertise. However, this study provides valuable evidence that ZipFix has the potential to improve patient outcomes and revolutionize sternal closure techniques.

About this Article -

This article was crafted using a human-AI hybrid and collaborative approach. AI assisted our team with initial drafting, research insights, identifying key questions, and image generation. Our human editors guided topic selection, defined the angle, structured the content, ensured factual accuracy and relevance, refined the tone, and conducted thorough editing to deliver helpful, high-quality information.See our About page for more information.

This article is based on research published under:

DOI-LINK: 10.1016/j.hlc.2018.01.010, Alternate LINK

Title: Zipfix Versus Conventional Sternal Closure: One-Year Follow-Up

Subject: Cardiology and Cardiovascular Medicine

Journal: Heart, Lung and Circulation

Publisher: Elsevier BV

Authors: Pouya Nezafati, Ali Shomali, Mahdi Kahrom, Sahar Omidvar Tehrani, Minoo Dianatkhah, Mohammad Hassan Nezafati

Published: 2019-03-01

Everything You Need To Know

What is the ZipFix system?

The ZipFix system is a biocompatible, cable-tie-based sternal closure device made from poly-ether-ether-ketone (PEEK). It is designed to close the sternum after open-heart surgery as an alternative to the traditional method. Its significance lies in its potential to offer advantages like flexibility, ease of use, and a strong, stable closure compared to conventional methods. The use of ZipFix aims to improve patient outcomes by reducing complications like pain and sternal dehiscence.

What is sternal dehiscence and why is it important?

Sternal dehiscence is the separation of the sternal edges, a potential complication following sternotomy. It's significant because it can lead to reoperations, prolonged recovery times, and increased patient discomfort. In this context, the study compared the rates of dehiscence between patients who underwent sternal closure with ZipFix and those who had traditional wire closure. The study aimed to determine if ZipFix could reduce the incidence of this complication, which directly impacts patient recovery and overall well-being.

What is traditional wire sternal closure?

Traditional wire sternal closure involves using stainless steel wires to close the sternum after open-heart surgery. It's been the gold standard due to its simplicity and low cost. However, it has downsides, including the risk of complications like dehiscence and infections. These complications can lead to the need for reoperations and extended recovery periods. The study compared the outcomes of this method to the ZipFix system, which sought to offer a superior alternative.

How was the study structured to compare ZipFix and traditional wire closure?

The study compared two methods: ZipFix and traditional wire sternal closure. It involved 326 patients who underwent cardiac surgery. After the sternotomy, patients were randomly assigned to receive either ZipFix or conventional steel wires. The study then tracked various factors over a year, including pain levels, dehiscence rates, and infection rates. The key goal was to determine whether ZipFix could provide better outcomes compared to the established method, focusing on patient comfort and complication reduction.

What factors did the study use to compare ZipFix and traditional wire closure?

The study monitored pain severity using a visual analog scale (VAS) where patients rated their pain during cough. Additionally, researchers assessed sternal dehiscence, which involved clinical findings. Lastly, they monitored infections, including incisional and organ/space infections. The comprehensive monitoring of these factors allowed researchers to evaluate the effectiveness of ZipFix in reducing patient discomfort, improving healing, and minimizing complications compared to the traditional wire method.