Patient Information and Care Manual

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Prudence Mercy Willis
6 years ago
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Risk after open heart surgery Instability, infections and resulting reoperations are major risk factors

During the operation, the chest bone is cut in the middle from top to bottom.

While coughing or abrupt movement, the wires can break or cut through the bone.

$The Posthorax support vest is worn 6-8 weeks after the operation until the bone fracture has completely$

2 Risk after open heart surgery Instability, infections and resulting reoperations are major risk factors after heart surgery and can result in up to 30% mortality. During the operation, the chest bone is cut in the middle from top to bottom. Cut through sternum After the operation, the two halves are held together with several thin steel wires. While coughing or abrupt movement, the wires can break or cut through the bone. Thin stainless steel wires The POSTHORAX support vest stabilizes the broken chest bone, relieves the wires of pressure and reduces pain while coughing and during rehabilitation. The Posthorax support vest is worn 6-8 weeks after the operation until the bone fracture has completely healed. During this time the vest should be worn day and night, like any regular cast. posthorax A5_V1_patient.indd :21

The Function and Efficiency of the Posthorax Sternum Support Vest was tested in 3 Studies: 1. Biomechanical Study, Biomechanical Institut, University of Vienna 40 patients 2.

Cohort Study University Heart Centre Hamburg, Germany 2200 patients Conclusion of these studies: Consistent and correct use of the POSTHORAX Support Vest significantly reduces the risk of sternal

3 The Function and Efficiency of the Posthorax Sternum Support Vest was tested in 3 Studies: 1. Biomechanical Study, Biomechanical Institut, University of Vienna 40 patients 2. Multicenter prospective randomized trial, Vienna, Austria 2500 patients 3. Cohort Study University Heart Centre Hamburg, Germany 2200 patients Conclusion of these studies: Consistent and correct use of the POSTHORAX Support Vest significantly reduces the risk of sternal (chest bone) wound healing complications and much prolonged hospitalization time. (1) Gorlitzer M et al: A Newly Designed Thorax Support Vest Prevents Sternum Instability After Median Sternotomy - Ejcts (2) A prospective randomized multicenter trial shows improvement of sternum related complications in cardiac surgery with the Posthorax support vest ICVTS Posthorax support vest Two cushions placed to the left and right of the chest-bone provide antero-posterior (front to back) stabilization 1. Before the operation: To get used to the support vest you should wear it for some time before the operation. 2. After the operation: Start wearing it as early as possible. 3. How long to wear? 6 8 weeks 4. When to wear? Day and night 5. Removing? During body care only Patient response Hi, Yesterday I received the PRO vest. It s great. My father can breath normally, and he doesn t feel such big pain. Thank you very much, regards from Poland, Agnieszka Figlewicz Ladies and gentlemen, Grateful thanks for providing the chest bone support vest. It has helped me very much after the operation and was an indispensable healing device. Now two months after the operation I feel very well and thank you very much. With cordial greetings Klaus Dieter Rassenbruch, Leipzig posthorax A5_V1_patient.indd :21

User Manual Posthorax Support Vest Single patient product 1 2 3 4 Step 1: Picture 1: Have someone measure your size with a measuring tape as shown in

The front of the vest with its cushions is placed directly over the sternum (chest bone), so a measure below that, for example over the stomach or over the

S = 60 70 cm M = 70 90 cm L = 90 120 cm XL = 120 150 cm XXL = 150 210 cm Step 2: Choose ladies or gentlemen support vest.

(Cushions placed upside down produce uneven pressure!) Step 3: Picture 2 & 3 Close buckle and velcro fi rst close the top buckle, then the bottom velcro.

4 User Manual Posthorax Support Vest Single patient product Step 1: Picture 1: Have someone measure your size with a measuring tape as shown in Picture 1. Start measuring from the back, then under the armpits to the top of the chest. The front of the vest with its cushions is placed directly over the sternum (chest bone), so a measure below that, for example over the stomach or over the breast for ladies, will give an incorrect size. S = cm M = cm L = cm XL = cm XXL = cm Step 2: Choose ladies or gentlemen support vest. The cushions are ergonomically fi tted. In case you remove the cushions, reattach with the wider end on TOP. (Cushions placed upside down produce uneven pressure!) Step 3: Picture 2 & 3 Close buckle and velcro fi rst close the top buckle, then the bottom velcro. The cushions are placed to the left and right, parallel to the chest bone. Step 4: Picture 4: Now pull the vest down on the back below the shoulder blades. Patient exhales. How to close the side bands: Step 5: Picture 5: Patient breathes in now tighten by pulling both upper side bands simultaneously, until the elastic band is fully extended - and close. Patient exhales. posthorax A5_V1_patient.indd :21

5 6 Step 6: Picture 6: Patient breathes in again now tighten by pulling both lower side bands simultaneously, until the elastic band is fully

The elastic rubber bands attached to the side bands (breathing mechanic) allow for normal breathing, the stop mechanic prevents overextension of

Now adjust the cushions so they are fl at on the chest. 7a 7b 8 Correct fi t: The front section of the support vest covers the chest bone length.

The support vest should be below the armpits.

two cushions (wide end ON TOP) Use some pressure to fi xate the cushions to the bra Combination is complete: Support Vest + Ladies bra IF THE VEST

5 5 6 Step 6: Picture 6: Patient breathes in again now tighten by pulling both lower side bands simultaneously, until the elastic band is fully extended - and close. Patient exhales. See Pictures 7a and 7b shows the breathing mechanic on the vest as described above. The elastic rubber bands attached to the side bands (breathing mechanic) allow for normal breathing, the stop mechanic prevents overextension of the thorax. Step 7: Picture 8: Close the shoulder bands one after the other, so that a light pressure on the shoulders is achieved. Now adjust the cushions so they are fl at on the chest. 7a 7b 8 Correct fi t: The front section of the support vest covers the chest bone length. The back section of the vest is located below the shoulder blades. The patient should feel a light pressure from the cushions towards his chest. The support vest should be below the armpits. Including the bra into the support vest Open buckle and velcro Take off the two cushions Attach both sides of the bra to the vest Re-attach the two cushions (wide end ON TOP) Use some pressure to fi xate the cushions to the bra Combination is complete: Support Vest + Ladies bra IF THE VEST MOVES UP IN THE BACK, DO NOT TIGHTEN SHOULDER STRAPS, JUST PULL THE VEST BACK DOWN AGAIN! ONCE THE VEST IS FITTED, OPEN IT ONLY USING THE FRONT BUCKLE AND VELCRO! PLEASE WATCH OUR INSTRUCTIONAL VIDEOS: posthorax A5_V1_patient.indd :21

$The vest is worn until the fracture has completely healed (6-8 weeks) POSTHORAX Sternum Support Vest POSTHORAX Sternum Support Vest with BRA To determine your size: With a fl exible measuring tape,$ you start measuring from the back, then under the armpits to the top of the chest.

you start measuring from the back, then under the armpits to the top of the chest.

size. Article Nr. Specification / Size Chest circumference in cm 15.0202 Universal sternum support vest S (small) 60-70 10.0202 Ladies sternum support vest M (medium) 70-90 10.

6 POSTHORAX PRO STERNUM SUPPORT VEST Used in the ward after patient mobilization and in rehabilitation. The vest is worn until the fracture has completely healed (6-8 weeks) POSTHORAX Sternum Support Vest POSTHORAX Sternum Support Vest with BRA To determine your size: With a fl exible measuring tape, you start measuring from the back, then under the armpits to the top of the chest. The front of the vest with its cushions is placed directly over the sternum (chest bone), so a measure below that, for example over the stomach or over the breast for ladies, will give an incorrect size. Article Nr. Specification / Size Chest circumference in cm Universal sternum support vest S (small) Ladies sternum support vest M (medium) Ladies sternum support vest L (large) Ladies sternum support vest XL (X large) Ladies sternum support vest XXL (XX large) Bra ladies cup B attached to sternum support vest fl exible (80+) Bra ladies cup C attached to sternum support vest fl exible (90+) Bra ladies cup D attached to sternum support vest fl exible (100+) Bra ladies cup E attached to sternum support vest fl exible (110+) Gentleman sternum support vest M (medium) Gentleman sternum support vest L (large) Gentleman sternum support vest XL (X large) Gentleman sternum support vest XXL (XX large) SPECIFICATION AND CARE POSTHORAX PRO sternum support vest Shell 100 % cotton Cushion 100 % PU foam Machine wash at 70 C or less. NO HOSPITAL WASH Iron at low setting May be dry cleaned in any type of solvent normally used in dry cleaning processes except trichloroethylene Do not use chlorine bleach Tumble dry at low setting posthorax A5_V1_patient.indd :21

7 FAQ Can I relax the support vest during the night, or take off? NO - in the sleep phase abrupt movements and strong cough can occur frequently and the stabilization is therefore essential! Do I have to wear the support vest also in rehabilitation? YES - the support vest should be worn about 6-8 weeks until the sternum is healed. Can I take my own bra instead of the Posthorax support bra? The Posthorax support bra is specially designed to fi t the support vest. If a patient wants to wear her own bra, it must be examined for the right function by the physician / care personnel. Where can I buy a second Support Vest to change? A second support vest can be ordered directly from the company, please send an to order@posthorax.com. How do I know my Support Vest is worn correctly? If its comfortable and you feel a light pressure on your chest from front to back. This pressure stabilizes the two chest bone halves and holds them together. If you miss this feeling of light pressure, the vest is too loose, functionality of the support vest is not correct. If you feel too much pressure, and almost pain, it is too tight. Doctors response The staff in the 1st Surgical Department of the heart center Hietzing, Vienna and our patients experience daily the extraordinary effects of this new product. Since we treat all patients with the Posthorax sternum vest it is a win for all we highly recommend Posthorax to every heart center. Prim. Univ. Doz. Dr. M. Grabenwöger, Dr. Michael Gorlitzer Heartcenter Vienna, Austria Correct application and stringent use of the Posthorax sternum support vest as a single patient product provides highly signifi cant results preventing deep sternal wound infections. Phd. Dr. Florian Wagner University Hospital Hamburg, Germany We have used the vest for more then 6 months in more than 500 patients. We are very pleased with the result. What we have been seeing is that the patients better and earlier according to the physiotherapist. M.D. Ph.D Hans Jonsson Department of Cardiothoracic Surgery, Karolinska University Hospital Stockholm posthorax A5_V1_patient.indd :21

POSTHORAX LIMITED, 20 Springfield Road, Crowley, West Sussex, RH11

Rudolf-Waisenhorn-Gasse 39, 1230 Vienna, Austria Phone +43.720.

, Laurinska 9, 811 01 Bratislava, Slovakia Phone +421

8 POSTHORAX LIMITED, 20 Springfield Road, Crowley, West Sussex, RH11 8AD, United Kingdom Phone POSTHORAX GmbH, Rudolf-Waisenhorn-Gasse 39, 1230 Vienna, Austria Phone , Fax POSTHORAX s.r.o., Laurinska 9, Bratislava, Slovakia Phone , Fax website: posthorax A5_V1_patient.indd :21

Sternum Instability in Clinical Practice

Sternum Instability in Clinical Practice in Clinical Practice Hans Jonsson M.D Ph.D. Department of Cardiothoracic Surgery and Anesthesiology Karolinska University Hospital Is that a problem in open heart surgery? Yes!! We must stabilize sternum