Quote from momdebo
Anyone out there familiar with the use of sternal plates being used in addition to figure 8 wiring post CABG? What is the healing time? Are they supposed to click and clack like the tin man afterward and if so, for how long?
A sternal plating will be used if the patient is a redo and has an unstable sternum, or if the surgeon is worried about the sternum healing without the plating being used. Example, an obese diabetic patient with IMAs used, you worry about the integrity of the sternum in this type of patient for several reasons-diabetes and IMA use can cause poor wound healing since good oxygenated blood flow may not be getting to the sternum causing increased risk of infection, and depending on how obese the patient is, there is always possibility of wound opening up, obese patient on top of patient at high risk for infection increases chances of problem with wound, so the sternal plate will hopefully prevent numerous complications. Healing time will vary based on number of things just like any other bypass patietn-health prior to surgery, length of time in hospital prior to surgery (increased LOS in hospital will increase exposure to nosocomial bugs), patient hx-vascular problems, diabetic, smoker, antibiotic coverage, surgeon, good post op wound care, and a lot more but that is a rough start.
As far as a clicking, you may hear a large pericardial rub because there is inflammation of the pericardium. I'm not sure what other type of clicking you have heard, but valve patients can also have a click noise if a mechanical valve is used. Also, if the patient is thin, poorly nourished, has little fat tissue, or loses a lot of weight, a rub may occur.