title: A prospective randomized multicenter trial shows improvement of sternum related complications in cardiac surgery with the Posthorax support vest.
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.
authors.affiliation: Department of Cardiovascular Surgery, Hospital Hietzing, Vienna, Austria. michael.gorlitzer@wienkav.at
authors.forename: Michael
authors.initials: M
authors.lastname: Gorlitzer
authors.forename: Florian
authors.initials: F
authors.lastname: Wagner
authors.forename: Steffen
authors.initials: S
authors.lastname: Pfeiffer
authors.forename: Sandra
authors.initials: S
authors.lastname: Folkmann
authors.forename: Johann
authors.initials: J
authors.lastname: Meinhart
authors.forename: Theodor
authors.initials: T
authors.lastname: Fischlein
authors.forename: Hermann
authors.initials: H
authors.lastname: Reichenspurner
authors.forename: Martin
authors.initials: M
authors.lastname: Grabenwöger
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001458:Bandages; D006348:Cardiac Surgical Procedures / Q000009:adverse effects* / Q000379:methods; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D011482:Protective Devices; D012016:Reference Values; D018570:Risk Assessment; D018709:Statistics, Nonparametric; D056346:Sternotomy / Q000009:adverse effects* / Q000379:methods; D013529:Surgical Wound Dehiscence / Q000401:mortality / Q000517:prevention & control*; D013530:Surgical Wound Infection / Q000401:mortality / Q000517:prevention & control*; D016019:Survival Analysis; D016896:Treatment Outcome; D014945:Wound Healing / Q000502:physiology