QualiBreath - Sternum and Thorax Support

QualiBreath is a nurse designed sternum and thorax support. Made specifically to help open heart surgery patients recover faster, with less complications, less pain and less chance of readmissions.

Read more about QualiBreath below or select a topic from the index to jump to the relevant section.

Patients can purchase from here:

 

What problems could patients face after open heart surgery?

 

Patients that undergo open heart surgery face a variety of risks during recovery. 
Specially if they are in the so called high risk group. 
It has been observed that 50 to 80% of these complications are diagnosed after discharge from the hospital.
Sternal infections, pulmonary complications, and pain are the most common and can increase the mortality rates drastically. 
Furthermore, the costs for hospitals and other health care providers rise significantly when treating postoperative complications. 

Patients may also experience prolonged pain, clicking and popping of the sternum, sternal instability, discomfort, and in some cases non-union of the sternum. 

Common symptoms after sternotomy procedures:

Incisional pain

  • Sternotomy wound
  • Drainage site

Respiratory pain

  • Deep breathing
  • Coughing, sneezing

Muscle pain

  • Sore respiratory muscles
  • Sore ribs, shoulders, back, and neck

Wound healing issues

  • Superficial Infection
  • Deep sternal infection
  • Dehiscence

Psychological issues

  • Feelings of weakness
  • Ineffective coping
  • Dissatisfaction with postoperative care

Functional limitations

  • Problems with eating
  • Sleeping difficulties

Why do sternal closures need external support?

There are various reasons to consider external chest supports for open heart surgery patients:

  • Deep Sternal Wound Infections: It's reported that the incidence of Deep Sternal Wound Infections during hospital stay is up to 3.51%. 
    After discharge, this may increase to 7.3% incidence.

  • Mortality rate of Deep Sternal Wound Infections ranges from 9% up to 47%. 

  • Increased risk for women and obese patients:
    Statistically it has been observed that women with Medium bra cup size have 12.3 times higher risk and women with Large bra cup size have 38.5 times higher risk of developing a Deep Sternal Wound Infection.

  • Chronic pain and pulmonary complications: It has been reported that Pulmonary Complications range from 8% to 79% and that chronic pain ranges from 17% to 56%.

  • The average cost of sternal wound complications:
    While the average cost of open heart surgery without complications is around $20.000 (USD) the average cost of treating sternal wound complications raises the costs to around $60.000 (USD) with 18-20 additional hospital days.

 

What is QualiBreath?

Designed by a Nurse, QualiBreath is a chest surrounding brace. It provides constant support and stabilisation of the sternum thanks to its elastic material. 
It's adjustable and can be tightened to a near rigid state. 
Special bar handles are built into the brace so that patients can grasp them to tighten the brace even more. This is specially useful when coughing, sneezing, doing respiratory therapy, straining, or moving. 

Why is lateral support (from each side) on the breast bone important?

Any broken bone is supported from both the in- and outside until it has healed. A sternum, or breast bone, is no exception. It needs external support because it is vulnerable to the patient's chest movements when breathing, coughing, sneezing, straining, and performing daily activities.

The QualiBreath chest band protects and stabilises the breast bone by giving constant support and it complements and protects the internal closure made by the surgeon.
It also relieves pain by reinforcing the rib muscles that may be sore after surgery, and encourages deeper breathing needed after surgery.
Furthermore it empowers patients with extra support when coughing, sneezing, straining.

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Why is extra support during coughing and sneezing important?

 

Any cough or sneeze causes a sudden, sharp rise in internal chest pressure that places strain on the breast bone. The patients need to counteract such pressure to protect and stabilise their breast bone and to secure the safe healing of the wound. Integrated, easy-to-grasp bar handles in the QualiBreath help to do just that.

QualiBreath has unmatched comfort and functionality and can be used day and night, even for a long time if necessary. It has been documented to decrease pain and to help prevention of complications after surgery, such as wound infections and separation of the breast bone.  

How does it work?

QualiBreath is a unique, nurse-designed sternum support for patients who need heart surgery with opening of the breast bone (sternotomy).
It reduces potential complications and advances the recovery process to get patients home and back to normal life sooner.

QualiBreath is the only dual functional chest support.
It combines two key functions:

  • constant reinforcement of the breast bone from the lateral sides
  • integrated bar handles for coughing, sneezing, and straining

 

 

What is the normal chest wall movement during breathing?

Restful breathing: The diaphragm does most of the work with only small movements in all 3 directions (abdominal breathing).

Breathing during exercise and stress: The lateral and anterior-posterior movements increase (thoracic breathing)

How does coughing or sneezing affect chest wall movement 

Reflex-caused sequence of events:

  • Contraction of the diaphragm with inhalation of air
  • Epiglottis closure and vocal cords contraction
  • Abdominal muscles contraction forcing the diaphragm upwards
  • Significantly increased intra-thoracic pressure (up to 300mmHg)
  • Sudden release of air through the epiglottis and vocal cords

 Chest wall movements

 


Constant protection and support:

The wound and breast bone are constantly protected by the elastic, firm, ventilated, and remarkably light material. QualiBreath is positioned high at the front on the chest, so the upper abdominal region is not covered, and the shoulder straps secure a correct position at all times.
QualiBreath has a left-sided, adjustable closure and the level of tension can be adjusted to be as tight as possible, while patients still feel comfortable and can breathe freely. Patients gain comfort and a better posture, which improves breathing and can help with clearing secretions from the lungs.

QualiBreath sternum brace
QualiBreath is closed by Velcro at the left side, so the wound is undisturbed.
Opening the shoulder strap on QualiBreath sternum and thorax support
Adjustable shoulder straps attached by Velcro at the front keep a correct position.


Pain control when coughing or sneezing:

A pair of bar handles are integrated in the QualiBreath material so patients can increase the surrounding tension to help control pain when needing to cough, sneeze or strain. Deep breathing with engagement of the diaphragm is not only crucial after surgery to avoid lung complications, deep breathing is also an important way to relieve stress. With less pain, a better posture, improved breathing and free hands, it is easier for patients to do the exercises that hospital staff will recommend for a speedy recovery after surgery.

How QualiBreath supports the chest and allows for deep breathing
The upper abdomen is uncovered, so patients can breathe freely.
Using the integrated handles on QualiBreath chest support
Patients grasp the bar handles by their thumbs and bring the bars together for more chest support.

Patients get in control of their recovery:

QualiBreath is placed directly on the patient's skin and is a constant “reminder” to protect the breast bone and wound. The handles are always ready to grasp directly or through clothing for more support when needed. QualiBreath is placed high at front on the chest. It can be pulled lower at the back if patients feel it sits too high in the armpits. AxillaPads are available to clip onto the upper margin of QualiBreath. Have a look out our full range of accessories such as the QualiPad seatbelt protector and washing net for garment care.

QualiBreath sternum support with AxillaPads
AxillaPad perspiration pads can be used for extra comfort under the armpits.
QualiBreath chest support with crossed shoulder straps
The shoulder straps can be uncrossed to lower the position at the backside.

When is it used?

QualiBreath is recommended to be used after all open heart surgeries or other interventions in the chest area that require a sternotomy. 

Furthermore, it is highly recommended for patients in the the high risk group.

Patients that are considered to be in the high risk group for developing postoperative complications can be identified with the following risk factors and are recommended to wear QualiBreath immediately after surgery continuously for 6 to 8 weeks.

Risk factors for sternal wound infection:

  • Obesity
  • Diabetes
  • COPD (Chronic Obstructive Pulmonary Disease)
  • Macromastia (large breast size)
  • Current smokers
  • Chronic cough
  • Osteoporosis
  • Preoperative renal failure
  • Previous myocardial infarction
  • Use of bi-lateral mammary arteries for CABG

Risk factors for pulmonary complications:

  • All same factors as for sternal wound infections
  • Atelectasis caused by anesthesia
  • Diaphragmatic dysfunction
  • Pain
  • Immobility
  • Ineffective cough
  • Neurological injury
  • IMA dissection
  • Inflammatory response to CPB
  • Low core temperature

Risk factors for postoperative persistent pain are linked to psychosocial elements such as anxiety, depression, catastrophizing, illness perception, poor coping strategy, low sense of control, poor social support and expectations

How is it used?

How to Measure for the best size:

10 reasons to use QualiBreath after open heart surgery: 

1. Dual-functional external chest support
Constant lateral support on the sternum and patient-activated reinforcement handles during coughing, sneezing, pain.

2. Documented positive effect on patient’s entire recovery process
Improves sternal stability, pain relief, ease of breathing, comfort, patient function, ease of activities and exercise.

3. Decreases deep sternal wound infections
Documented effect of a firm, constant external support on the chest and sternum.

4. Keeps the lower lung lobes and the upper abdominal area free
Secures unrestricted deep respiration and increased comfort.

5. Supports the respiratory muscles and relieves pain
The firm, elastic material encourages deep breathing and coughing to clear the lungs of atelectasis and secretions.

6. Compliments the internal closure from the outside
Increases the potential for an optimal sternal alignment.

7. Unmatched comfort
Adjustable tension with the ability to loosen or tighten to near rigid state which increases compliance with usage in the hospital and at home.

8. Important adjunctive recovery treatment
Constant “reminder” to the patient that encourages mobilization and exercise of the upper limbs which increases blood supply and stimulates healing of the fractured sternum.

9. Important psychological aid to put the patient in control of his own recovery
Helps the patient to handle responsibility for sternum protection and wound care after discharge.

10. Decreases health care costs and gives a hospital significant return of investment
Prevents sternal infections, decreases postoperative pain and pulmonary complications.

Patients can purchase from here:

Accessories:

QualiBreath can be used with the following accessories: 

CryoPouch: A practical tool to provide pain relief without drugs. Fits directly on the QualiBreath sternum and thorax support. The CryoPouch has two pockets for cold packs and is designed to provide cold treatment to relieve incision pain and discomfort after sternotomy and other surgeries in the chest.

 

 

AxillaPads: The AxillaPads are soft, comfortable cotton pads which will help patients to protect the product from excessive underarm sweating. Simple to attach on the binder. They also provide additional padding under the armpits.  

QualiPad: A postoperative wound protection pad to use in the car after cardiac surgery. It protects the wound or trauma area from the seat belt in the car after hospital discharge. It's easy to apply to the seat belt and patients can leave it on - no need to remember to bring it. Made of a comfortable, soft material it maintains the safety of the seat belt with the softness of a pillow.

Female patients with breast size below cup D can also use QualiBreath. For additional comfort and privacy, the breast cover accessory can be added simply by attaching its upper corner velcro pieces to the inside of QualiBreath and by closing the elastic band around the chest. The breast cover is not a bra but will cover any breast tissue appearing below the QualiBreath.

 

 

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