The Bra Project: Preventing Wounds in Women After Sternotomy.

Background: Women with large breasts are at risk for wounds after sternotomy.

Local problem: Over 12 months, 7 of 110 female patients who underwent sternotomy (6.4%) had 274 additional hospital days related to pressure injuries and sternal dehiscence after sternotomy. The financial burden for the longer stays was more than $751 000. The purpose of this quality improvement initiative was to implement a soft, comfortable bra to prevent wounds and sternal dehiscence in female patients after sternotomy.

Methods: Nurses implemented a new bra that reduced wound tension, had stretchable material that could expand for swelling, did not absorb moisture, and was available in a range of sizes to accommodate all women. Staff members measured patients' chest circumference before surgery and dressed patients in the bra in the operating room immediately after surgery. Patients wore the bra for breast support 20 to 24 hours a day for 6 weeks after surgery.

Results: The new bra was used for 82 patients. No patients who wore the bra developed sternal dehiscence or chest pressure wounds. The wound incidence rate decreased from 6.4% to 0%.

Conclusion: Female patients undergoing sternotomy should be dressed in a comfortable and appropriately sized bra immediately after surgery and should wear it for 6 weeks. Such a bra can help prevent sternal dehiscence and pressure injuries.