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An example of a typical postoperative pillow.
Many hospitals supply heart patients with pillows, often called heart- chest- or cough- pillows. The purpose is to help patients to protect their sternum when they need to cough or sneeze. The question is: Could such pillows do more harm than good?
Many charity organisations supply the pillows free of charge, all with great intentions. Often the pillows are shaped as a heart, which gives a sense of comfort. They also give the impression that the hospital and its staff care about each patient and his/her recovery. Some pillows may have prints of the anatomical heart and/or the logo of the hospital.
The patient is instructed to hug the pillow, when they need to cough or sneeze. There is one problem with this: The pillow is not attached to the patient, and patients cannot carry it around at all times, like when they need to visit the bathroom. They have to reach out for it, when a cough or sneeze comes up. Will they manage to get the pillow in time? Or has the cough or sneeze already taken place when the pillow got picked up from ...the bed, a chair, a table, or the floor!
Heart pillows can get in touch with many sources of infection. This may present a risk for the sternal wound when the pillows are hugged and pressed against it. Patients continue to use the heart pillow after discharge for a long time, and may bring it around with them in and out of their home. This furthermore exposes the pillow to sources for infection.
Heart shaped pillow.
Coughing or sneezing causes a sudden rise in internal thoracic pressure. Pressing a pillow against the sternum gives counter-pressure during coughing or sneezing. However, when the patient is not coughing or sneezing, such inward pressure on the fractured sternum bone may disturb a precise alignment of the sternal bone halves and hinder a healthy healing. The problem is that many patients may use pillows for comfort during pain and press it towards the sternum, also when they don't need to cough or sneeze.
Dr. Arthur Tucker, St. Barts and the London Hospitals, is the author of a study reported in the UK news paper The Telegraph (See the article here). “Dr. Tucker found 30 different types of infection in a sample of pillows taken from hospital wards, posing a significant risk of infection!” The study was cited by The London Times and reported by Fox News: “Pillows in hospitals have been overlooked as breeding grounds for infectious germs — including superbugs”.
In another study from the University of Manchester “Pillows: A Hot Bed Of Fungal Spores”, reported in Science Daily (See the article here), the authors described how they “discovered millions of fungal spores right under our noses -- in our pillows”.
Medical literature reports that 50% to 80% of sternal wound infections are diagnosed after discharge (1, 2). The cost of sternal wound infections are reported to be between $40,000 to $80,000 (3, 4). Research is needed to verify whether the heart pillows could be a potential culprit for sternal complications.
Heart pillows could do more harm than good for the patients’ health and the health care providers’ bottom line. Hospitals should consider to use specialty products dedicated to sternotomy patients such as QualiBreath sternum and thorax support.
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1. Jonkers D, Elenbaas T, Terporten P, Nieman F, Stobberingh E. Prevalence of 90-days postoperative wound infections after cardiac surgery. European Journal of Cardio-thoracic Surgery 23 (2003) 97–102
2. Ridderstolpe L, Gill H, Granfeldt H, Ahlfeldt H, Rutberg H. Superficial and deep sternal wound complications: incidence, risk factors and mortality. Eur J Cardiothorac Surg. 2001 Dec;20(6):1168-75.
3. Graf K, Ott E, Vonberg RP, Kuehn C, Haverich A, Chaberny IF. Economic aspects of deep sternal wound infections. European Journal of Cardio-thoracic Surgery 37 (2010) 893—896
4. Speir AM, Kasirajan V, Barnett SD, Fonner E. Additive Costs of Postoperative Complications for Isolated Coronary Artery Bypass Grafting Patients in Virginia. Ann Thorac Surg 2009;88:40–6