Journal articlesQuality improvement: chest support to aid recovery following median sternotomy in female cardiac patients

Quality improvement: chest support to aid recovery following median sternotomy in female cardiac patients

29/06/17 | Acute wounds, Products, Research | Melissa Rochon, Dahnia Gibb, Clair Mullins, Ana Marie Soler Castells, Natalie Gott, Angela Neville, Carlos Morais, Joseph Viana, Hannah Ashpole, Ann Jakeman, Toufan Bahrami

Background: Female gender is an independent risk factor for surgical site infection (SSI) in coronary artery bypass graft (CABG) surgery. Previous studies demonstrated that SSI risk increases with breast size. In the UK, an affordable and suitable bra for cardiac surgery was not widely available in all sizes. Aim: To design a practical chest support for female cardiac patients, for in hospital and at home use. Methods: Using a quality improvement approach, the BHIS™ bra was developed. Continuous prospective SSI surveillance was performed by trained personnel. As a quasi-randomised design, retrospective propensity score matching was performed to adjust for non-random bra assignment. Variables of interest included bra type, cup size, operation type, operative urgency, cardiopulmonary bypass, body mass index, diabetic status, renal function and pre-operative stay. Results: 348 adult female patients with BHIS bra were matched with 348 adult female patients who wore a standard compression surgical bra and/or own bra. In the adjusted analysis, the BHIS bra had less SSI (Odds Ratio 0.56, 95% Confidence Interval [CI] 0.2324, 1.3557). Conclusions: The BHIS bra was designed specifically for the female cardiac surgical patients. Quality improvement data and retrospective case-study analysis suggests that BHIS bra is a useful adjunct to support wound healing. Further study via randomised control trial is needed.