In spite of the fact that heart surgeries have become increasingly common, with thousands of various invasive heart-related procedures being performed daily in the U.S. alone, the recovery from these surgeries remains a challenge in healthcare. However, a new generation of medical devices known as sternum support devices are playing a key role in helping heart patients recover more quickly and avoid post-surgery complications.
Heart surgery requires a median sternotomy, a surgical procedure where surgeons perform a vertical inline incision along the sternum, after which the sternum itself is divided and separated widely to access the heart. It goes without saying that, while heart surgeons are now well-versed in this procedure, it still remains incredibly invasive for the patient. Following surgery, surgeons close the sternum with stainless steel wires, which heals in the majority of the cases without any signs of complications. However, in 1 to 5% of sternotomy cases, patients develop infections as well as mediastinitis (inflammation of the tissues in the mid-chest, called mediastinum, and a life-threatening condition with an extremely high mortality rate if recognized late or treated improperly) and wound dehiscence, a surgical complication in which a wound ruptures along the surgical suture. These complications, while not prevalent, are still a concern to doctors, as they put the patient’s health and life in jeopardy, and also contribute to higher medical costs in effectively treating heart patients after surgery.
In a study from 2000 entitled “The Sternum Support Harness for the Treatment of Sternotomy Pain and the Prevention of Sternal instability” published in the Cardiopulmonary Physical Therapy Journal, physical therapist Meg Meisler discusses a small clinical trial performed on patients submitted to heart surgery and exhibiting risk factors for sternotomy complications and how they benefited from using a sternum support device.
Specifically, to alleviate the pain associated with sternotomy wounds and help control dehiscence, patients were treated with a sternum support device. There are variations in the design of sternotomy support devices, however, the device described in the study consisted of a broad belt that is stabilized on the chest by suspenders on shoulders and has a handle on each end. The device is intended to support patients’ chest and so, during an activity or upon coughing, the patient can close the belt by using the handle and encircle his chest, stabilizing the chest cavity and immobilizing the chest wound.
The trial suggests that a sternum support device helps to control the pain associated with a median sternotomy incision and stabilizes patients’ chest while coughing and taking deep breaths (important physical therapy interventions following surgery to allow a successful clearance of secretions, but usually severely impaired by pain associated with the surgical intervention). The support has the advantage of allowing patients to promote chest stabilization when necessary, such as during therapy, or when waking up during the night.
Meisler went on to explain that the participants in the clinical trial did benefit from the device in curtailing post-surgery complications, since consistent compression of the sternal wound led to less aggravation, which in turn allowed the wound to heal quickly and cleanly. As a result of the efficacy demonstrated in the study, the researcher suggested that a closer look at dehiscence of sternal wounds comparing traditional splinting methods with the sternum support device — preferably applied immediately after surgery — could bear out more data supporting its use in further lowering the incidence of post-surgery complications.
Traditionally, sternum support devices have been prescribed to heart patients to act as a non-medicinal means of dealing with post-operative pain associated with the median sternotomy procedure. However, because the device also allows patients more confidence and support in coughing, breathing deeply, and partaking in physical rehabilitation, the design has also been found to benefit the avoidance of infections as well.