QualiBra Advanced FAQ's


Generally about QualiBra Advanced:

  1. What is QualiBra Advanced?
    QualiBra Advanced is a multi-functional device that combines an external sternum support with a unique purpose-designed brassiere for fuller-sized women who have had a sternotomy procedure. It is nurse-designed and consists of a chest encircling, elastic, adjustable sternum band, integrated with a bra with mid-front velcro closure that has elastic cotton cups with vertical bands on each side of the breasts attached to the shoulder straps by adjustable velcro.

  2. What does multi-functional mean?
    It means the QualiBra Advanced device functions in several ways. 1. It gives a constant, lateral support on the sternum by the firm, circumferential and adjustable sternum band. 2. The sternum band has integrated pockets that can be used by the patient to obtain additional encircling tension on the chest for support during coughing, sneezing and straining. 3. The bra part has central vertical bands to keep the sternal wound free from breast tissue. 4. It has lateral vertical bands to prevent gravitation of the breast tissue from pulling on the sternal wound, and 5. A mid-front under-bust closure which allows for easy wound care without the need to open the bra which maintains breast support and preserves the woman’s dignity.

  3. Who should use QualiBra Advanced?
    It is for women with a bra cup size D or higher who have had a sternotomy procedure (opening of the breast bone) e.g. open heart surgery. QualiBra Advanced is strongly recommended for all patients at high risk for postoperative complications e.g. obesity, diabetes, preoperative renal failure, previous myocardial infarction, osteoporosis, age, chronic obstructive pulmonary disease (COPD), chronic cough, and current smokers. 

  4. Is QualiBra Advanced only for sternotomy patients?
    Primarily yes, since the special design is focussed on achieving a healthy healing of the sternum bone by keeping the sternal wound dry and free, as well as giving lateral support to the sternum to avoid complications like dehiscence and deep sternal wound infections. QualiBra Advanced may be useful for larger sized women who experience breathing discomfort and pain, e.g. thoracotomy, rib fractures and chest trauma patients.

  5. Has QualiBra Advanced been clinically proven?
    The integrated sternal support in QualiBra Advanced is a version of QualiBreath, which is the only external sternum support that has been evaluated for a broad range of important criteria for improving postoperative recovery. It was shown to significantly decrease pain and sternal separation in patients with chronic sternal instability, and it had a positive effect on patient function, comfort, ease of breathing, and ease of exercise activities. Other evaluations of various external chest supports have shown that a firm external complementary support to the internal sternal closure significantly decreases the risk of sternal wound infections.

What QualiBra Advanced does for the patient:

  1. What can QualiBra Advanced do?
    It gives a constant lateral support on the sternum from the external side which complements the internal surgical closure of the sternum and help patients to manage breathing and pain after sternotomy surgeries. Furthermore the nurse-designed bra gently keeps the sternal wound free of breast tissue, and it supports the weight of the breast tissue to prevent its gravitation to the lateral sides during a horizontal position.

  2. Why do fuller-sized women need the QualiBra Advanced after a sternotomy?
    It protects them against postoperative complications. Women with larger breasts are exposed to a higher risk of complications, like wound rupture, infections or dehiscence due to the weight of breast tissue which causes a constant pull on the sternotomy wound.

  3. Why should the breasts be “separated” after a sternotomy?
    Keeping the breast tissue gently away from the sternal wound without pulling, helps to keep the wound area dry and free from heat and moisture build-up thereby decreasing potential wound infections. It also promotes a more aesthetic wound healing in a very visible position which is important for women of all ages.

  4. Why is lateral support of the sternum necessary?
    After a sternotomy procedure the two sternum halves are only held together internally by wires or plates, which is the only force to withstand a concurrent strain of the sternum in lateral direction. Complementing the internal sternal closure from the outside by a lateral support has been shown to be highly effective and to significantly decrease sternal complications.

  5. How can QualiBra Advanced give a firm sternum support when it is elastic?
    Any elastic material can be stretched to an almost non-elastic state. The specially selected elastic material used in QualiBra Advanced is unidirectional and has a precisely monitored elasticity of 100% +/-10%. This results in a firm, conforming support all around the chest. The controlled elasticity combined with the correct sizing and adjustable closure provides a firm, encircling chest support without jeopardizing comfort.

  6. Does QualiBra Advanced restrict breathing?
    No. The QualiBra Advanced sternum band is designed with a calculated height and rests above the breasts so the lower lung lobes and the upper abdominal area are not covered. The result is that the sternum, the ribs and respiratory muscles are supported, which encourages deeper breathing and engagement of the diaphragm which promotes a healthier, abdominal breathing.

  7. Can QualiBra Advanced relieve pain?
    Yes. The firm, unidirectional, elastic support to the ribs and respiratory muscles helps to relieve pain in a safer, non-pharmaceutical way helping to decrease the risk of patients possibly becoming addicted to pain medications.

  8. How can QualiBra Advanced assist during coughing, sneezing or straining?

    Thanks to the pockets placed on each side of the sternum in the chest band, the patient can easily insert the thumbs or 4 fingers in each pocket and bring them together or over each other. This action reinforces the encircling chest support, counteracts the increased thoracic internal pressure during coughing, sneezing or straining, and relieves pain and protects the sternum.

  9. Does QualiBra Advanced have any psychological effects?
    Yes. The constant support of the chest and breasts gives patients a feeling of being held firmly together thus reducing anxiety about potential harm to the sternal wound from breast gravity pull, coughing, sneezing, straining or breathing exercises. QualiBra Advanced is a constant “reminder” for patients to protect their sternum, and the pockets assist them to regain independence and confidence in their ability to manage themselves anytime without the need for help from hospital personnel.

How and when to measure and choose the correct size:

  1. How to choose the correct size of QualiBra Advanced?
    Measure the patient’s chest above the breasts and under the armpits and select the appropriate size on the sizing chart included on all brochures, posters and on www.qualiteam.com. The sizes are XS, S, M, L, XL, XXL, XXXL and 4XL sizes, like T-shirts. If it is not possible to take the measurement, estimate the patients T-shirt size for selecting the size. QualiBra Advanced is supplied with a standard cup that thanks to the elasticised cotton material covers bra cup sizes from D and up to size F. If the cup size is considered to be larger than F ask for a “Plus” sized cup.

  2. When is the measurement taken for the QualiBra Advanced?
    Ideally it should be taken in the admission department before surgery and the size clearly noted in the patients journal so the QualiBra Advanced can be placed on the patient already in the OR, or in the ICU.

How to use QualiBra Advanced:

  1. When should QualiBra Advanced be applied?
    Ideally in the operating room by placing it on the bed before the patient is transferred after surgery. Using this practice is undemanding for staff and less challenging for the patient

  2. What are the central breast bands for?
    The central breast bands keep the sternal wound free of breast tissue thereby promoting a healthier and more aesthetic wound healing, as well as preventing heat and moisture generation on the wound which decreases the potential for infection.

  3. What are the lateral breast bands for?
    The purpose of the lateral breast bands is to prevent gravitation of breast tissue to the sides so the weight does not pull on or rupture the sternal wound when the woman is leaning backwards or is in a supine position

  4. Can the central and lateral breast bands be adjusted?
    Yes, all 4 vertical bands are attached to the shoulder straps by an adjustable Velcro closure. This is possible since each shoulder strap divides in a Y-fashion where each “arm” connects to the central and vertical breast band.

  5. How is QualiBra Advanced closed?
    All closures of the underbust band of the bra, the shoulder straps, and the sternum band are at the front and with velcro which enhances comfort and ease of wound care. The closure is an easy 3-step procedure: 1. Under-bust band. 2. Shoulder straps. 3. Sternum band.

  6. Why is QualiBra Advanced closed at the front?
    A front closure is safer and more comfortable for a newly operated patient and is easier to open for wound care. It also makes it much easier and quicker for staff to open in emergency situations where quick access to the chest might be needed. Furthermore any backward movement of the arms should be avoided until the sternum has healed, since such movement “opens” the chest and puts excessive and possibly damaging stress on the sternum.

  7. How is wound care possible?
    Simply open the sternum band while the under-bust band remains closed. Breast support is thus maintained during wound care and the patient experiences less pain. Maintaining the under-bust band closed also makes it easier and quicker to close the sternal band again after wound care. In addition many women appreciate to have their breasts covered during care when possible.
  1. Why is the under-bust band wider than in normal brassieres?
    The under-bust band is wide to maximise comfort and fitting. It also prevents that the materials crawl up underneath the breast tissue which is a problem with many brassieres.

  2. How can drainage tubes be accommodated with QualiBra Advanced?Normally the drainage tubes will exit underneath the elastic under-bust band which can be loosely closed over them. Depending on a woman’s build and figure, it may be an option to let the drains exit above the
    under-bust band.

  3. Why are the QualiBra Advanced cups double-layered?
    For comfort. This means that there are no seams against the woman’s skin to cause potential irritation

  4. Why are the shoulder straps wider than normal brassieres?
    This is to prevent digging into the shoulders and to heighten comfort.

  5. Is the QualiBra Advanced one-size-fits-all?
    No. The sizing is determined by the sternum band so the chest measurement above the breasts and under the armpits must be taken to get the correct size. The breast cups are almost a one-size-fits-all since the standard cup version ranges size D,DD and E. The Plus version cups covers size F and above.

  6. What is the correct position of the QualiBra Advanced sternum band?
    It must be positioned above the breasts over the mid-lower part of the sternum.

  7. Why is there no underarm shaping on the QualiBra Advanced sternum band?
    Because cutting out an area in the sternum band under the armpits would eliminate the importantencircling tension efficiency and the lateral support of the sternum in an area corresponding to the depth of an underarm shaping.

  8. What to do if patients feel QualiBra Advanced bothers them under the arms? 
    This may happen when patients are bedridden more than expected which can cause the QualiBra Advanced sternal band to be pushed up at the back side and thereby in the armpits too. The shoulder straps can be readjusted for a lower position of QualiBra Advanced at the back side. If this is not enough, we recommend to use the Axilla perspiration pads to protect the armpits.

  9. Can the patient position the QualiBra Advanced on their own?
    Not immediately after surgery. Initially it should be applied by a health care professional in the OR or the ICU. When patients are mobile and know the correct, safe movements for protection of the sternum, they can easily position QualiBra Advanced without help.

  10. How does the QualiBra Advanced pockets work?
    The pockets should be used by both hands symmetrically while the upper arms are kept close to the chest. The patient places each thumb or 4 fingers under the material fold that forms a pocket on both sides of the sternum. Bringing the 2 hands together or on top of each other will stretch the elastic sternum band, and add extra encircling support to the chest to increase the lateral reinforcement on the sternum.

  11. When should patients use the QualiBra Advanced pockets?
    The pockets should be grasped for additional reinforcement during coughing, sneezing or straining. It is also much appreciated during deep breathing exercises or other painful situations.

  12. Is the distance between the QualiBra Advanced pockets the same in all sizes? No, the distance between the pockets becomes proportionally larger, the larger the size

  13. Should QualiBra Advanced be used during the day or at night only?
    It should be used both day and night for as long as the sternum bone is healing, which means at least 8 weeks.

  14. How much should the QualiBra Advanced sternum band be tightened?When QualiBra Advanced is placed on the patient immediately after surgery before she is fully awake after the anaesthesia, we recommend to start with a lighter closure at the first Velcro attachment on the band. When the patient is awake and cooperative, the band can be tightened more towards the most inner Velcro position to achieve a tighter and firmer support.

  15. Does QualiBra Advanced increase perspiration?
    Normally not since the QualiBra Advanced sternum band material is ventilated. Patients with excessive perspiration under the armpits may want to use the accessory, the Axilla perspiration pads which easily can be exchanged and washed as needed

  16. Can the QualiBra Advanced cause irritation to the skin?
    Most unlikely. All seams as well as the manufacturer’s labels, are on the outside of the material facing away from the patient’s skin. The material is free of natural rubber latex (no NRL), also called Latex-free. Furthermore there are no buckles or other rigid items to cause pressure points on the skin

  17. Is QualiBra Advanced washable? Yes. For longevity of the elastic material we recommend to wash it at 30°C/86°F without tumble drying.

  18. Should QualiBra Advanced only be used during the stay in the hospital?
    No. QualiBra Advanced is a “one-per-patient” product and should follow the patient home. It should be used until the sternum bone has healed properly (at least 6-8 weeks). Patients can use it for longer if they feel it helps to manage breathing and pain and that it supports their activities.

  19. How can the pockets be used when QualiBra Advanced is worn under the clothes? The pockets are easily grasped through most lighter materials used such as T-shirts or blouses.It is usually not necessary to wear an open shirt to use the pockets – QualiBra Advanced can be completely hidden and used discreetly under the patient’s clothes. 

QualiBra Advanced and other devices:

  1. Is QualiBra Advanced a compression bra?
    No, it is a nurse-designed external sternum support combined with a purpose-designed bra that addresses the special needs fuller-sized women have after a sternotomy procedure.

  2. Why is a compression bra or a standard bra not suitable after a sternotomy?
    Compression bras constrain the breast tissue towards the chest wall which squeezes the breasts against the sternotomy wound. This promotes the formation of heat and moisture on the wound, which is important to avoid since it “invites” to bacterial growth and infection. Likewise, a standard bra is usually designed to create a cleavage which also promotes heat and moisture build-up. In addition, both a compression and standard bra cannot prevent the breast tissue from falling to the lateral sides when a woman is in a horizontal position. Such pull of the breast tissue directly on the sternal wound will increase the risk of wound rupture and infection, wound healing deformation and other complications after surgery.

  3. Can a sports bra be used as a post-operative garment?
    It is not recommended since bras for athletic use aim at giving compression and to immobilise the breasts which allow women to perform sports activities in a comfortable and painless way. These devices are designed for sports activities, usually need to be pulled over the head, have no front closure, and do not meet the specific needs both patients and health care personnel have after surgery e.g. breast support and free access to the wound, pain relief, easy to apply, easy to open for wound care. Furthermore putting on most sports bras forces movements which apply stress on the sternum which is prohibited in the healing period.

  4. Is using a pillow an alternative to QualiBra Advanced?
    No. A pillow can not constantly support the sternum. Traditionally patients have often been advised to press a pillow against the sternum when coughing or sneezing. However, pressing a pillow or any other device directly inward on a fresh sternum wound and bone can do more harm than good, and may be a source of infection since pillows often fall on the floor or get in contact with other potential infection sources. Furthermore, pressing a pillow between large breasts may put strain on the suture line increasing the risk of rupture. In addition, it is counterproductive for posture and recovery to have patients holding on to a pillow all the time.