QualiBreath - Sternum and Thorax Support

Taking a holistic approach to patient care, the nurse-designed QualiBreath sternum and thorax support with accessories were created with the primary goal of reducing pain and complications following surgery. Its specific focus lies in helping open heart surgery patients, enabling them to achieve faster recovery, experience less pain, and significantly decrease the likelihood of readmissions.

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

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What problems could patients face after open heart surgery? 

Patients who undergo open heart surgery may encounter a range of challenges during their recovery that could result in complications, particularly if they fall into the category often referred to as the high-risk group. Patients considered in high risk for complications are those with diabetes, kidney disease, lung disease, or peripheral arterial disease, as well as obese patients and women with larger breast sizes.

The most common complications after surgery are pain, pulmonary and sternal wound infections, which can disrupt the healing process. In addition, patients may endure lingering discomfort, unsettling sensations like clicking and popping of the sternum, and even sternum instability, with rare instances of non-union.

Astonishingly, a staggering 50 to 80% of these complications are detected only after patients leave the hospital's care, further highlighting the criticality of postoperative interventions. Notably, the financial burden on hospitals and healthcare providers rise significantly when treating postoperative complications. 

Common issues after sternotomy procedures:

Respiratory pain
• Deep breathing
• Coughing, sneezing, straining

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

Incisional pain
• Sternotomy wound
• Drainage site

Wound healing issues
• Superficial Infection
• Deep sternal infection
• Dehiscence

Psychological issues
• Feelings of weakness
• Ineffective coping

Functional limitations
• Problems with eating
• Sleeping difficulties
• Mobilization difficulties

Why do patients need external sternal support?

Pain relief:
There are compelling reasons to consider utilizing the QualiBreath external chest support for patients undergoing open heart surgery, with pain relief being of paramount importance. Following the procedure, patients often experience discomfort in their ribs and muscles, resulting in pain during essential activities such as breathing, coughing, sneezing, straining, and moving.

To manage this pain, patients are typically prescribed opioids, powerful narcotics known for their effectiveness. However, it is crucial to acknowledge the inherent risks associated with opioids, including the potential for addiction and the possibility of unused medication entering the broader community.

Therefore, it is in everyone's best interest to minimize the reliance on opioids. QualiBreath, with its comfortable support to sore ribs and muscles, and its CryoPouch accessory designed for cold treatment targeting incision pain, is a promising adjunctive tool in achieving this goal.

 

Prevention of infections:

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 constant chest movements when breathing, and in particular during coughing, sneezing, straining, and performing daily activities.

To ensure unrestricted breathing while stabilizing the sternum, it is essential to limit any external support device to the upper torso only. The lower lung lobes and upper abdominal areas should not be covered, allowing for unrestricted respiration, as well as providing the additional advantage of promoting abdominal breathing and engaging the diaphragm. This approach contributes to the prevention of post-operative pulmonary complications.

Stabilization of the sternum furthermore provides an optimal setting for effective soft-tissue healing which minimizes the risk of infection in the surgical incision which could expand to the deeper layers of tissue and the sternum bone.

 

Enhanced protection for high risk patients:

Statistically obese patients and those with diabetes, kidney or lung diseases, or other conditions have a higher risk of developing infections or other complications. Both the pain relieving function and the preventive potential of infections which QualiBreath can provide, should be considered when planning for an effective postoperative treatment for these patients.



Decreasing the 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. Just preventing 1 patient from encountering complications could pay for many months supply of QualiBreath.

 

What is QualiBreath?

QualiBreath, created by a nurse, is a chest brace with two key functions that provide important benefits to patients. Firstly, it offers constant pain relief by supporting the sore ribs and muscles while also stabilizing the sternum. Secondly, it provides additional support to the chest as needed during painful situations throughout the recovery period. Why is lateral support (from each side) on the breast bone important?


QualiBreath is crafted from lightweight, breathable, and stretchable material, ensuring a comfortable fit for any body shape. It is adjustable and can be tightened to provide a firm level of support according to individual preference.
The brace includes special bar handles that patients can grip to further tighten the brace. This feature is particularly useful for alleviating pain during activities such as coughing, sneezing, respiratory therapy, straining, or movement.

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Why is extra support during coughing and sneezing important?

The importance of additional support during coughing and sneezing lies in the fact that these actions generate a sudden and significant increase in internal chest pressure. This heightened pressure puts immense strain on the breastbone from the inside, leading to pain and discomfort. It is crucial for patients to have a means to counteract this pressure, safeguarding their breastbone, reducing pain, and promoting a safe healing process for the wound.
QualiBreath, equipped with its integrated and easy-to-grasp bar handles, precisely serves this purpose, providing the necessary support during these actions.

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 attach and fold over the upper border 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.
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:

Increased risk factors in the postoperative period:
Atelectasis caused by anesthesia
Diaphragmatic dysfunction
Pain
Immobility
Ineffective cough
Neurological injury
IMA dissection
Inflammatory response to CPB
Low core temperature

 

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.

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Accessories:

QualiBreath can be used with the following accessories: 

CryoPouch: A practical tool to provide pain relief without narcotics. 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. Apply the cold packs for 20 min. and repeat every 2 hours or as recommended by a health care professional.

 

 

AxillaPads: The AxillaPads are soft, comfortable cotton pads which adds comfort under the armpits and will help patients to protect the product from excessive underarm sweating. Simple to attach and fold over the upper border of the binder.

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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