Obese patients who undergo cardiac surgery often face complications with their sternal wounds. These complications can lead to additional surgeries and longer hospital stays, resulting in increased costs. In an effort to address this issue, researchers at Universitätsmedizin Mainz in Germany conducted a study to assess whether wearing the PosthoraxTM vest could reduce sternal wound complications after cardiac surgery in obese patients.
The study took place from August 2014 to July 2015 and included 129 elective obese patients with a BMI over 30kg/m2. These patients were fitted with the PosthoraxTM vest prior to their surgeries. It was important for patients to strictly adhere to wearing the vest throughout the study. Any patients who did not follow this requirement were eliminated from the study. A control group of 131 similar patients who did not wear the vest was also included for comparison.
The results of the study showed that the deep sternal wound complication rate in the vest-wearing group was 4.7% (6 out of 129 patients), while the control group had a complication rate of 10.7% (14 out of 131 patients). The groups were matched in terms of BMI, age, operation time, and time on the respirator. However, the vest-wearing group had a significantly shorter stay in the ICU and achieved earlier mobilization compared to the control group (p<0.0001).
It is important to note that the significant differences in ICU stay and mobilization raise questions about the comparability of the two groups. These factors may contribute to the reduced complication rate observed in the vest-wearing group. However, it is worth considering that these factors are typically part of the postoperative course without complications. The surgical technique for wound closure also plays a role in preventing complications, and this can vary depending on the surgeon.
Despite these considerations, the researchers at the clinic apply the PosthoraxTM vest to every obese patient undergoing cardiac surgery via median sternotomy. This is done to reduce the risk of postoperative deep sternal wound complications and associated costs. The results of the study support the effectiveness of the vest in reducing complications by half. However, further research may be needed to fully understand the impact of the vest on obese cardiac patients and to explore its potential benefits in a broader context.