Sternal Talon for sternal closure in cardiothoracic surgery

The technology described in this briefing is the Sternal Talon. It is a device used during surgery to close the sternum after procedures involving a sternotomy.

The innovative aspects are that the talon does not need to be drilled or driven into the bone, holds more securely than wires and can be left in place indefinitely in patients who do not need reoperation. This may allow the patient to return to normal activities sooner.

The intended place in therapy would be as a sternal closure device in people who have had cardiothoracic surgery.

The key points from the evidence summarised in this briefing are from 5 studies (n=233 patients in total), comprising 1 randomised controlled trial and 4 case series. The randomised trial suggested that using Sternal Talon may lead to better outcomes than wire closure, but this was not statistically significant. The case series indicated that Sternal Talon is a safe and effective device in high‑risk patients, with a low rate of major complications.

Key uncertainties around the technology are that there is currently very little comparative evidence available.

The cost of Sternal Talon ranges from £479.28 to £689.84 (exclusive of VAT). Commonly 3 Sternal Talons are used per patient, costing from £1,437.84 to £2,069.52. The cost of sternal closure using standard steel wires ranges from £13.06 to £14.42. The resource impact would be almost identical to standard care, aside from the cost of the technology.