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DOI: 10.1055/s-0029-1191400
A newly designed thorax support vest prevents sternum instability after median sternotomy
Objective: Sternum infection remains one of the primary causes of postoperative morbidity and mortality after median sternotomy. We report the clinical efficacy for primary reinforcement of the sternum with a new design of thorax support vest.
Methods: A prospective randomized study including 455 patients was started in September 2007 to evaluate the effectiveness of the Posthorax® sternum vest (Epple Inc., Vienna, Austria). 175 patients were treated with the sternum dressing postoperatively (group A) and 280 patients did not receive the vest (group B). Several clinical and operative data were evaluated. All patients were recorded using the STS risk scoring analysis for mediastinitis after cardiac surgery.
Results: The median age and gender distribution were comparable in both groups. All patients described the vest as comfortable. Preoperative data like renal failure, chronic obstructive pulmonary disease, peripheral artery disease, and myocardial infarction did not differ significantly. There were more patients with diabetes in group A (38.2% versus 31.8%). 53.1% underwent coronary bypass grafting, 13.4% aortic valve replacement, 6.4% mitral valve repair and 23.7% concomitant cardiac procedures. The median risk factor analysis and body mass index were comparable. In the follow up period up to 90 days, in group B we observed 5.4% sternum instability, and in group A only 0.4% (p<0.05). There was no reoperation in patients treated with this sternum vest compared to fifteen in the control group.
Conclusions: The use of the Posthorax® sternum is a valuable and well tolerated tool to prevent sternum instability after cardiac surgery.