QualiBra Advanced - Breast and Sternum Support
QualiBra Advanced is a nurse designed breast and sternum support. Made specifically to help open heart surgery patients recover faster, with less complications, less pain and less chance of readmissions.
Read more about QualiBra Advanced below or select a topic from the index to jump to the relevant section.
Patients can purchase from here:
Index
(click on the topic to jump to the section)
What problems could patients face after open heart surgery?
Female patients that undergo open heart surgery face a variety of risks during recovery.
Specially if they are in the so called high risk group. And, even more so if the patient has a large breast size.
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 for female patients after sternotomy procedures:
Some of these symptoms can be aggravated if the patient has large breasts.
The gravitational pull from the breast tissue, when lying in bed or standing up, can pull on the incision.
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:
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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.
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Mortality rate of Deep Sternal Wound Infections ranges from 9% up to 47%.
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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.
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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%.
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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 QualiBra Advanced?
Designed by a Nurse, QualiBra Advanced is a breast support with an integrated chest surrounding brace. It supports the breasts to avoid them pulling on or squeezing against the sternotomy wound. 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 pocket 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.
Patients can purchase from here:
Why should a standard bra not be used?
Standard bras tend to enhance cleavage by squeezing the breasts towards the center of the chest.
This will increase heat and moisture in the surgical wound, which will increase the risk of infection and may prolong hospital stay. Also, most bras
are closed at the back and a backward movement of the arms is not allowed until the wound has healed since such movement opens the chest and strains
the breast bone. Last, but not least, a standard bra has no chest surrounding band to protect and stabilize the breast bone.
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 QualiBra Advanced 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.
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 QualiBra Advanced help to do just that.
QualiBra Advanced has unmatched comfort and functionality and can be used day and night, even for a long time if necessary. Chest support devices such as the QualiBreath have 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?
QualiBra Advanced is a unique, nurse-designed breast and 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.
QualiBra Advanced is the only dual functional breast and chest support.
It combines two key functions:
- constant reinforcement of the breast bone from the lateral sides with breast support
- 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
Constant protection and support:
The wound and breast bone are constantly protected by the elastic, firm, ventilated and remarkably light material of the chest band. The chest band is positioned above the breasts and has a left-sided, adjustable closure. 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 your breathing and can help with clearing secretions from your lungs.
The chest surrounding band is closed by Velcro at the left side, so your wound is undisturbed.
The chest band is integrated with the breast support at each side and dictates the choice of size.
Pain control and aesthetic wound healing:
Patients can increase the surrounding tension to help control pain when needing to cough, sneeze or strain. Insert the thumbs or fingers in the integrated pockets on the chest band and bring the hands together or over each other. The soft and comfortable bra cups are made of absorbent elasticized cotton that have vertical support bands on each side of the breasts. These bands can be adjusted to prevent the pull of gravity on the wound and to keep it free from breast tissue to avoid heat and moisture buildup. When the wound is not squeezed, healing will be more esthetically pleasing.
Grasp the pockets by your thumbs or insert your fingers and bring them together for more chest support.
Vertical bands prevent pulling and keep the breast bone wound free to heal neatly.
Comfort and dignity during wound care:
Wound inspection and care is easy and cause less pain with QualiBra Advanced, and it is not needed for patients to uncover their breasts. Just one of the bands need to be opened, either the sternum band or the under-bust band, and the health care staff has full access to the wound while the support of the breasts is maintained. Which band to open will depend on the position of your wound and your body shape. QualiBra Advanced also acts as a constant “reminder” to protect the breast bone and wound, both in the hospital and at home. The chest band pockets are always there for them to grasp when they need them.
The sternum band can be opened for wound care while the under-bust band remains closed.
Depending on wound position or body shape it could be more convenient to open the under-bust band with the sternum band closed.
When is it used?
QualiBra Advanced 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 QualiBra Advanced 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 QualiBra Advanced after open heart surgery:
1. Dual-functional external chest and breast support
Constant lateral support on the sternum and patient-activated reinforcement handles during coughing, sneezing, pain. Includes adjustable breast support.
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.
QualiBra Advanced can be used with the following accessories:
CryoPouch: A practical tool to provide pain relief without drugs. Fits directly on the QualiBra Advanced 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 and therefore don't necessarily need QualiBra Advanced 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.
