BACKGROUND: Stainless steel wiring remains the most popular technique for 
primary sternal closure. Recently, a multifilament cable wiring system (Pioneer 
Surgical Technology Inc., Marquette, MI, USA) was introduced for sternal closure 
and has gained wide acceptance due to its superior resistance to tension. We 
aimed to compare conventional steel wiring to multifilament cable fixation for 
sternal closure in patients undergoing major cardiac surgery.
METHODS: Data were collected retrospectively on 1,354 patients who underwent 
sternal closure after major cardiac surgery, using either the multifilament 
cable wiring system or conventional steel wires between January 2009 and October 
2010. The surgical outcomes of these two groups of patients were compared using 
propensity score matching based on 18 baseline patient characteristics.
RESULTS: Propensity score matching yielded 392 pairs of patients in the two 
groups whose baseline profiles showed no significant differences. No significant 
differences between the two groups were observed in the rates of early mortality 
(2.0% vs. 1.3%, p=0.578), major wound complications requiring reconstruction 
(1.3% vs. 1.3%, p>0.99), minor wound complications (3.6% vs. 2.0%, p=0.279), or 
mediastinitis (0.8% vs. 1.0%, p=1.00). Patients in the multifilament cable group 
had fewer sternal bleeding events than those in the conventional wire group, but 
this tendency was not statistically significant (4.3% vs. 7.4%, p=0.068).
CONCLUSION: The surgical outcomes of sternal closure using multifilament cable 
wires were comparable to those observed when conventional steel wires were used. 
Therefore, the multifilament cable wiring system may be considered a viable 
option for sternal closure in patients undergoing major cardiac surgery.