[Application effects of armor chest straps in patients with sternal dehiscence after repair surgery].

J Yang, L. Wang, W. F. Zhang, Y Chen, H. Guan
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Abstract

Objective: To investigate the application effects of armor chest straps in patients with sternal dehiscence after repair surgery. Methods: This study was a retrospective cohort study. The 11 patients who were admitted to the First Affiliated Hospital of Air Force Medical University (hereinafter referred to as the hospital) from March 2020 to March 2021 and used conventional chest straps after sternal dehiscence repair surgery were included in conventional chest strap group. The 12 patients who were admitted to the hospital from April 2021 to March 2022 and used armor chest straps after sternal dehiscence repair surgery were included in armor chest strap group. A special team for sternal dehiscence repair was set up, and the nurses in charge in the team instructed the patients in 2 groups on the correct abdominal breathing method, and the members of the surgical team performed the personalized surgery and wore the corresponding chest straps for the patients in 2 groups. The abdominal breathing frequency and chest breathing frequency on the first day after surgery were recorded. The pain intensity at 6, 24, 48, and 72 h after surgery was self-rated by the patients using numerical rating scale. The time of the first active cough and the time of wound healing after surgery were recorded. At postoperative suture removal, the cutting length of sutures induced by respiratory exercise was recorded. Whether there were complications such as redness, swelling, and exudation in flaps within 2 weeks after surgery were recorded, whether there were complications such as wound dehiscence or infection during follow-up of 3-12 months were recorded, and the incidence proportion of postoperative complications was calculated. At 6 months after surgery, the patients' scar status was evaluated by the Vancouver scar scale. Results: The abdominal breathing frequency of patients in armor chest strap group was (16.3±1.2) times/min on the first day after surgery, which was significantly higher than (5.3±1.4) times/min in conventional chest strap group (t=20.00, P<0.05), and the chest breath-ing frequency was (1.2±0.8) times/min, which was significantly lower than (12.4±1.5) times/min in conventional chest strap group (t=22.36, P<0.05). The pain intensity scores of patients in armor chest strap group at 6, 24, 48, and 72 h after surgery were significantly lower than those in conventional chest strap group (with t values of 15.07, 14.70, 13.66, and 11.03, respectively, P<0.05). The time of the first active cough and the time of wound healing after surgery of patients in armor chest strap group were significantly sooner than those in conventional chest strap group (with t values of 5.51 and 8.90, respectively, P<0.05). At postoperative suture removal, the cutting length of sutures induced by respiratory exercise of patients in conventional chest strap group was 2.0 (0, 5.0) mm, which was significantly longer than 2.0 (1.0, 2.0) mm in armor chest strap group (Z=4.10, P<0.05). There was no statistically significant difference in the incidence proportion of postoperative complications of patients between the 2 groups (P>0.05). At 6 months after surgery, the scar score of patients in armor chest strap group was 4.1±1.4, which was significantly lower than 5.6±1.4 in conventional chest strap group (t=2.71, P<0.05). Conclusions: The application of armor chest strap in patients with sternal dehiscence after repair surgery can increase the abdominal breathing frequency, reduce the wound cutting force, effectively relieve postoperative pain, increase the first active cough and wound healing speed, and alleviate postoperative scar proliferation, achieving good application effect.
[铠甲胸带在修复手术后胸骨开裂患者中的应用效果]。
目的探讨胸骨修补术后胸骨开裂患者使用铠甲胸带的效果。方法: 采用回顾性队列研究:本研究为回顾性队列研究。将 2020 年 3 月至 2021 年 3 月空军军医大学第一附属医院(以下简称医院)收治的胸骨裂开修补术后使用常规胸带的 11 例患者纳入常规胸带组。将 2021 年 4 月至 2022 年 3 月期间入院并在胸骨裂开修补术后使用铠甲胸带的 12 名患者纳入铠甲胸带组。成立胸骨裂开修补术专项小组,小组主管护师指导两组患者正确的腹式呼吸方法,手术组成员为两组患者实施个性化手术并佩戴相应的胸带。记录术后第一天的腹式呼吸频率和胸式呼吸频率。术后 6、24、48 和 72 h 的疼痛强度由患者使用数字评分表进行自我评分。记录术后首次活动性咳嗽时间和伤口愈合时间。术后拆线时,记录呼吸运动引起的缝线切割长度。记录术后 2 周内皮瓣是否出现红肿、渗出等并发症,随访 3-12 个月是否出现伤口裂开或感染等并发症,并计算术后并发症的发生率。术后 6 个月,采用温哥华瘢痕量表对患者的瘢痕状况进行评估。结果铠甲胸带组患者术后第一天的腹式呼吸频率为(16.3±1.2)次/分,明显高于常规胸带组(5.3±1.4)次/分(t=20.00,P0.05)。术后 6 个月,铠甲胸带组患者的瘢痕评分为 4.1±1.4,明显低于常规胸带组的 5.6±1.4(t=2.71,P<0.05)。结论对胸骨裂开修补术后患者应用铠甲胸带,可增加腹式呼吸频率,减少伤口切割力,有效缓解术后疼痛,提高首次主动咳嗽和伤口愈合速度,缓解术后瘢痕增生,取得了良好的应用效果。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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