A prospective randomized multicenter trial shows improvement of sternum related complications in cardiac surgery with the Posthorax® support vest

• Published in: Interactive cardiovascular and thoracic surgery Vol. 10; no. 5; pp. 714 - 718
• Main Authors: Gorlitzer, Michael, Wagner, Florian, Pfeiffer, Steffen, Folkmann, Sandra, Meinhart, Johann, Fischlein, Theodor, Reichenspurner, Hermann, Grabenwöger, Martin
• Format: Journal Article
• Language: English
• Published: England European Association for Cardio-Thoracic Surgery 01.05.2010
• Subjects: Adult; Aged; Aged, 80 and over; Bandages; Cardiac Surgical Procedures - adverse effects; Cardiac Surgical Procedures - methods; Female; Follow-Up Studies; Humans; Male; Middle Aged; Prospective Studies; Protective Devices; Reference Values; Risk Assessment; Statistics, Nonparametric; Sternotomy - adverse effects; Sternotomy - methods; Surgical Wound Dehiscence - mortality; Surgical Wound Dehiscence - prevention & control; Surgical Wound Infection - mortality; Surgical Wound Infection - prevention & control; Survival Analysis; Treatment Outcome; Wound Healing - physiology; Infection; Sternum; Postoperative care; Mediastinitis
• ISSN: 1569-9293; 1569-9285
• DOI: 10.1510/icvts.2009.223305

Abstract Sternal instability, dehiscence and mediastinitis are major causes of morbidity and mortality in cardiac surgery. The aim of this analysis is to determine the effect of a Posthorax® support vest (Epple Inc, Vienna, Austria) after median sternotomy. One thousand five hundred and sixty cases were included in a prospective randomized multicenter trial. Patients were randomized as follows: 905 received a flexible dressing postoperatively (group A) and 655 patients were given a Posthorax® support vest (group B). Patients in groups A and B were well matched. Their mean age was 68 years (range: 34-87 years). The patient characteristics and operative data were equally distributed in both groups. The mean total hospital stay was significantly shorter in group B than in group A (A: 17.33±17.5; B: 14.76±7.7; P=0.04). Sternal wound complications necessitating reoperation during the 90 days follow-up period were observed in 4.5%. Reoperation rates were as follows: 3.9% in group A and 0.6% in group B (P<0.05). The use of the Posthorax® sternum support vest is a valuable adjunct to prevent sternum-related complications after cardiac surgery. In the 90 days follow-up period, additional surgical procedures were significantly reduced by the use of the support vest.