title: A Randomized Trial to Assess the Contribution of a Novel Thorax Support Vest (Corset) in Preventing Mechanical Complications of Median Sternotomy.
abstract: OBJECTIVE
  Mechanical complications of median sternotomy may cause significant morbidity and mortality in cardiac surgical patients. This study was aimed at assessing the role of Posthorax support vest (Epple, Inc., Vienna, Austria) in the prevention of sternal complications and the improvement of anatomical healing in patients at high risk for mechanical sternal dehiscence after cardiac surgery by mean of median sternotomy.
  
  
  METHODS
  A prospective, randomized, study was performed and 310 patients with predisposing factors for sternal dehiscence after sternotomy for cardiac surgery were included. The patients were divided into two groups: patients who received the Posthorax support vest after surgery, and patients who did not. Primary variables assessed included the incidence of mechanical sternal complications, the quality of sternal healing, the rate of re-operation, the duration of hospitalization, rate and duration of hospital, re-admission for sternal complications. Secondary variables assessed were the post-operative pain, the number of requests for supplemental analgesia and the quality of life measured by means of the EQ-5D format.
  
  
  RESULTS
  Patients using vest demonstrated a lower incidence of mechanical sternal complications, a better anatomical sternum healing, lower hospital stay, no re-operations for sternal dehiscence before discharge and lower re-admissions for mechanical sternal complication. In addition, patients using a vest reported a better quality of life with better freedom from limitations in mobility, self-care, and pain.
  
  
  CONCLUSIONS
  Our findings demonstrate that the use of the Posthorax vest reduces post-sternotomy mechanical complications and improves the healing of the sternotomy, the clinical course, and the post-operative quality of life.
authors.affiliation: Department of Cardiac Surgery, University Hospital of Novara "Maggiore della Carità", Novara, Italy.|Department of Science Health, UPO University, Novara, Italy.|"Policlinico di Monza" Hospital Group, Department Cardiac Surgery, San Gaudenzio Clinic, Novara, Italy.
authors.forename: Philippe P
authors.initials: PP
authors.lastname: Caimmi
authors.affiliation: Department of Science and Innovation Technology, UPO University, Alessandria, Italy. maurizio.sabbatini@uniupo.it.
authors.forename: Maurizio
authors.initials: M
authors.lastname: Sabbatini
authors.affiliation: Department of Thoracic Surgery, "Sotiria" Chest Diseases Hospital of Athens, Athens, Greece.
authors.forename: Emmanouil I
authors.initials: EI
authors.lastname: Kapetanakis
authors.affiliation: "Policlinico di Monza" Health Care Group, Department Cardiac Anaestehsiology, San Gaudenzio Clinic, Novara, Italy.
authors.forename: Silvia
authors.initials: S
authors.lastname: Cantone
authors.affiliation: Department of Cardiac Surgery, Beneficencia Portouguesa Hospital, Piracicaba, Brazil.
authors.forename: Marcus V
authors.initials: MV
authors.lastname: Ferraz
authors.affiliation: Department of Science Health, UPO University, Novara, Italy.
authors.forename: Mario
authors.initials: M
authors.lastname: Cannas
authors.affiliation: "Policlinico di Monza" Hospital Group, Department Cardiac Surgery, San Gaudenzio Clinic, Novara, Italy.
authors.forename: Ugo F
authors.initials: UF
authors.lastname: Tesler
keywords: Dehiscence; Postoperative care; Quality of life; Sternum; Surgery complications; Wound healing