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KMID : 1221920160090010066
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Journal of Korean Critical Care Nursing
2016 Volume.9 No. 1 p.66 ~ p.76
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Relationship between Lateral Position Change and Sternal Complications after Cardiac Surgery through Median Sternotomy
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Kang Young-Ae
Bae Su-Jin
Song Chie-Eun
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Abstract
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Purpose: This study was conducted to examine the relationship between lateral position change and sternal complications after cardiac surgery through median sternotomy.
Methods: This study was a retrospective descriptive case-control study, involving 241 patients who underwent cardiac surgery through median sternotomy. Data from October 2011 to September 2014 were collected.
Results: Sternal complications (i.e. dehiscence, sternal instability, mediastinitis) developed in 33 patients (13.7%). Primary symptoms of complications were discharge and erythema, and the mean time difference from surgery to appearance of symptoms was 15 days (range, 1-138 days). The factors associated with sternal complications were cancer comorbidity (, p=.039), internal mammary artery procedure (, p=.041), and duration of extra-corporeal membrane oxygenation (p=.033). Position change was not related to incidence of sternal complications (, p=.704). Pressure ulcers appeared in 63 patients (26.1%). Mean time difference from surgery until occurrence of ulcers was 6.7 hours (range, 0-323.0 hours), but position change was started from 132.4 hours (range, 27.1-503.2 hours) after intensive care unit admission.
Conclusions: These results provide baseline data to create a standard position change and activity protocol for patients after median sternotomy. Furthermore, the study could help clinical practitioners establish evidence-based nursing practices.
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KEYWORD
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Sternal complications, Position change, Median sternotomy, Cardiac surgery
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