Estimated Enrollment:	200
Study Start Date:	March 2008
Estimated Study Completion Date:	March 2009
Estimated Primary Completion Date:	March 2009 (Final data collection date for primary outcome measure)

Inclusion Criteria:1. Male or female. Women of childbearing potential must have a negative serum (or urine) human chorionic gonadotropin assay prior to surgery, and be willing to continue to use effective means of birth control for at least 180 days following surgery. Medically acceptable contraceptives include: (1) surgical sterilization (such as a tubal ligation or hysterectomy), (2) approved hormonal contraceptives (such as birth control pills, patches, implants or injections), (3) barrier methods (such as a condom or diaphragm) used with a spermicide, or (4) an intrauterine device (IUD). Contraceptive measures such as Plan B(TM), sold for emergency use after unprotected sex, are not acceptable methods for routine use.

2. Age ≥ 18 years. 3. Scheduled to undergo nonemergent on or off pump CABG and/or valve repair or replacement surgery through a full median sternotomy. 4. At higher risk for SWC, defined as the presence of any of the following factors: obesity (body mass index > 30), chronic steroid use (>6 month duration and currently using), severe COPD (FEV1 <50% predicted), planned bilateral IMA harvest, undergoing redo median sternotomy, and history of radiation to the chest. 5. Willing and able to provide written informed consent. 6. Available for evaluation from baseline until final evaluation at 180 days postsurgery.

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Exclusion Criteria:1. Undergoing emergency cardiac surgery (urgent surgery is allowed if informed consent is obtained and the study procedures can be performed). 2. Undergoing a significant concomitant surgical procedure (eg, carotid endarterectomy, aortic root repair or replacement, deep hypothermic circulatory arrest [DHCA], or pulmonary resection).

3. Undergoing a minimally invasive or a thoracic surgical approach. 4. Using a preoperative mechanical assist device or intraaortic balloon pump (IABP), if inserted for shock/low output syndrome (an IABP is allowed if it is inserted for unstable angina or low EF).

5. Active and significant systemic infection, eg, active endocarditis or a history of significant recurrent systemic infection. 6. Receiving antibiotic therapy within the 2 weeks before the date of surgery. 7. History of malignancy within the past year (except for squamous or basal cell carcinoma of the skin that has been treated, with no evidence of recurrence). 8. History of major organ transplantation, including bone marrow transplantation.

9. Recent history of significant drug or alcohol abuse. 10. Current immunosuppressive condition (eg, symptomatic human immunodeficiency virus [HIV] infection), defined as a CD4 count < 200 cells/mL3 of blood (use of steroids is not an exclusion criteria).

11. Female subject who is pregnant (including a positive pregnancy test at screening or baseline) or nursing.

Females of childbearing potential not practicing a birth control method with a high degree of reliability.

12. Postsurgical life expectancy ≤ 90 days, in the investigator's or sponsor's opinion.

13. Current participation or participation within 30 days before the start of this study in an experimental drug or device study or currently participating in a study during which the administration of investigational drugs within 90 days is anticipated. 14. Refusal to accept medically indicated blood products. 15. Moderate or severe pectus deformity.

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KLS Martin, L.P.

Sternal wound closure cardiac surgery sternal nonunion

Respiratory Tract Diseases Thoracic Diseases Wounds and Injuries Disorders of Environmental Origin

Mediastinitis Mediastinal Diseases Wound Infection

Respiratory Tract Diseases Thoracic Diseases Wounds and Injuries Disorders of Environmental Origin

Mediastinitis Infection Mediastinal Diseases Wound Infection