Prevention of Sternal Wound Infections with the Sternum External Fixation (Stern-E-Fix) Corset in Women

Selten, Koen; Zayat, Rashad; Tewarie, S. L.; Autschbach, R.

doi:10.1055/s-0039-1678908

Cited by 2 publications

(3 citation statements)

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“…The use of SEF, similar to that presented by Tewarie et al [49], as compared with applying a conventional bandage, also showed better results among females [50]. According to this survey, sternal wound infection occurred in 7% of patients in the intervention group vs. 17.6% in the control group (bandage) [50].…”

Section: Resultssupporting

confidence: 80%

“…it should be noted that in both these studies [49,50], the percentage of wound infection in control groups is significantly higher than in other surveys [38,39,51,52]. on the other hand, both studies [49,50] mentioned the name of the external fixation, which, along with the marketing description in the articles, raises a question whether it was research or advertisement.…”

Section: Resultsmentioning

confidence: 76%

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Critical review of the justification of limitations in physical therapy and activities of daily living in cardiac surgery patients

Vitomskyi¹

2022

Physiother Quart.

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IntroductionThe study aim was to analyse the justification of limitations in physical therapy and activities of daily living in patients after cardiac surgery via sternotomy.MethodsA narrative review design was followed. This study is the result of analysing and comparing the data obtained through investigating sternal closure stability after sternotomy, the load on the sternum during physical therapy, activities of daily living and coughing, as well as the effectiveness of sternum external fixation.ResultsSternum closure stability after sternotomy and the force of the load on the sternum during cough are greater than when performing upper extremity movements and most of the activities of daily living. The benefits of using sternum external fixation are not marked. Mathematically, most of the presented statistical benefits of sternum external fixation were achieved owing to the large number of individuals in the samples. Therefore, it is important to analyse such statistical indicators as odds ratio, attributable risk, the number needed to treat in terms of such a ‘harmful factor’ as lack of sternum external fixation. The use of sternum external fixation should be biomechanically grounded.ConclusionsConventional restrictions and recommendations for patients after cardiac surgery via sternotomy lack theoretical justification and research to confirm their necessity.

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Section: Resultssupporting

confidence: 80%

Section: Resultsmentioning

confidence: 76%

Critical review of the justification of limitations in physical therapy and activities of daily living in cardiac surgery patients

Vitomskyi¹

2022

Physiother Quart.

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“…Studies of SEF effectiveness are mainly focused on superficial wound infection (SWI), deep sternal complications (DSC), and sternal wound dehiscence (SWD). In particular, "vest -no vest" [5,9], "vest -bandage" groups of patients are compared [10,11,17,19]. One of the studies [19] reports on the ability of a corset to protect the sternum from dehiscence during a cough, the ease of use, functionality, preservation of lung function and aux-iliary respiratory muscle movement, as well as simultaneous prevention from excessive thorax expansion, excessive movement of the rib cage in an anterior and a lateral directions.…”

mentioning

confidence: 99%

Theoretical Model of Sternum External Fixation Functioning in Physical Therapy of Patients Following Cardiac Surgery via Sternotomy

Vitomskyi

2020

Scientific and practical journal

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Abstract. The purpose is to develop and analyze a theoretical model of sternum external fixation functioning as sternal precaution after cardiac surgery via sternotomy. Methods: theoretical modeling based on literature data. Results. The literature data, measuring the impact of sternum external fixation on the development of complications after cardiac surgery via sternotomy, do not present a proper report of the functioning mechanism or mechanical model of the interaction between the sternum and sternum external fixation. The first stage of theoretical model development included selecting the criteria based on the sternum anatomy, physiology of respiration, results of scientific research, which enabled to define key aspects of the theoretical model.The second stage included studying interaction of non-elastic SEF and sternum during a deep breath and a cough acting as main elements of inspiratory muscle training after cardiac surgeries; performing a similar algorithm of studying elastic type of SEF, which enabled to investigate and analyze preventive potential of SEF in relation to sternal dehiscence in the lateral direction. The third stage included the analysis of SEF restricting potential for anteroposterior stabilisation of the sternum. Since the use of sternum external fixation should not impede pulmonary function recovery after cardiac surgery and cannot restrict chest circumference increase with inhalation, sternum external fixation cannot properly function as sternal precaution when chest circumference is increased due to sternal edge dehiscence as well. The restricting effect of inelastic sternum external fixation will be possible only in case of a large dehiscence, when its size is bigger than the chest circumference increase during normal and deep breathing. Only when the circumference of inelastic sternum external fixation corresponds to the chest circumference after a full exhalation, the effect restricting dehiscence development will be possible. However, this condition is not practically feasible and does not comply with the need for pulmonary function recovery. As an example a barrel with iron rings that prevent it from expanding and emerging of dehiscence between the boards. However, this is not practically possible and is inconsistent with physiology of respiration. The restricting effect of elastic sternum external fixation will be possible in case the force of compression is greater than the force expanding the sternum during a cough, which will completely restrict inhaling and disable its practical use. The use of sternum external fixation must be biomechanically justified. The fact that the sternum is covered with soft tissues (muscles, which are joined with the bones of the sternum, shoulder blade and humerus; subcutaneous fat, which increases with excessive body weight) also reduces sternum external fixation effectiveness, as the existence of a soft and movable layer between the fixing parts and fixing means is a negative factor. On the other hand, dehiscence is a rare case among patients who do not use SEF. This confirms the priority of the sternal closure stability after sternotomy and the factors affecting it: the strength of bone tissue, the diameter of the wire, used during sternotomy, and the number of sutures. Conclusions. The theoretical model analyzed in this study confirms either the insignificant role of sternum external fixation or its complete absence in the prevention of sternal dehiscence in the lateral direction and anteroposterior displacement of sternum edges after sternotomy.

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Prevention of Sternal Wound Infections with the Sternum External Fixation (Stern-E-Fix) Corset in Women

Cited by 2 publications

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Critical review of the justification of limitations in physical therapy and activities of daily living in cardiac surgery patients

Critical review of the justification of limitations in physical therapy and activities of daily living in cardiac surgery patients

Theoretical Model of Sternum External Fixation Functioning in Physical Therapy of Patients Following Cardiac Surgery via Sternotomy

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