Transcript of video:
"Even the best surgical techniques cannot avoid that patients have various degrees of respiratory pain, sore ribs and muscles, and incisional pain after a sternotomy procedure.
Patients also have to deal with possible wound healing issues and functional limitations, - not to forget the psychological impact heart surgery can cause.
The most devastating and costly complications are sternal infections, postoperative pain and pulmonary complications.
On average 3.5% of patients get a deep sternal wound infection during hospital stay. This doubles to more than 7% at 90 days follow up, and more than half of these infections are diagnosed after discharge.
Chronic pain and pulmonary complications have a higher incidence which make them more costly for the health care system than deep sternal wound infections.
Women and obese patients have increased risk of infections proportional to the degree of breast size and obesity. Other patient groups with high risk are diabetics, osteoporotic, older patients, COPD - to mention some.
A deep sternal wound infection triples the cost of the procedure, and prolongs the hospital stay up to three weeks. Just avoiding one such complication saves a significant amount of money for health care providers.
The status of sternotomy procedures is that complication rates have not decreased over the last decade, and cardiac patients have a readmission rate of 16% within 30 days of surgery. This is the highest readmission rate of all patient groups!
Why have complications after sternotomy procedures remained steady, and why do cardiac patients have the highest readmission rates? The answer is most likely to be found in the postoperative recovery period while the sternum bone is healing.
Patients are often discharged early to save money, which shifts the responsibility for recovery and wound care to the patient and family members, or to rehabilitation clinics. How well prepared are they for taking this responsibility?
Are the efforts to save money by early discharge being offset during recovery?
There is no common consensus on guidelines to patients after sternotomy procedures. Hospitals usually make their own, which may vary from one to another, and they have limited control on whether patients follow the guidelines.
Patients are not routinely provided with dedicated preventive devices to protect the sternum, and are often just advised to use a pillow when coughing.
Heart pillows have never been scientifically tested to understand if they are good or bad for sternotomy patients, or whether they could be related to postoperative complications! Pillows are a source of infection when they fall on the floor, and they can cause the patient to reach for them in a sudden move when a cough comes up, which may cause friction between the sternal halves and result in a potential infection. The sternum bone is a healing fracture and should get the same protection as other bone fractures by stabilizing it from the outside.
No-one would recommend to pressure anything against a bone fracture in a 90 degree angle.
What can be done to decrease complications, readmission rates and the overall health care costs? There is no scientific evidence that pillows can solve the problem. There is scientific evidence that external chest support devices can decrease deep sternal wound infections, pain and pulmonary complications.
The QualiBreath sternum and thorax support is designed by a nurse and is the only device that has been evaluated for effects on all the issues patients are dealing with after surgery.
QualiBreath stabilizes the sternum by giving an efficient and constant lateral support which decreases the risk of deep sternal wound infection. The patient can grasp the integrated handles in a safe dynamic fashion to counteract peak internal thoracic pressures when coughing, sneezing or straining. Pain from sore ribs and muscles will be relieved by the comfortable, conforming support around the chest.
Posture is improved which stimulates deeper breathing, and makes clearance of secretions from the lungs easier, which may decrease potential lung infections. QualiBreath stimulates to activity and makes it easier to move which helps to prevent circulatory complications.
Last but not least, the sternum will be protected 24 hours a day and patients will be able to sleep comfortably wearing an external chest support. The QualiBreath sternum and thorax support is in the best position to decrease postoperative complications and readmission rates.
Scientific publications show the average costs of a deep sternal wound infection is $60.000 and procedures without complications are about $20.000. When a hospital performs 300 sternotomy procedures per year, and the average rate of deep sternal wound infection is 3.5% during hospital stay, 11 patients would get this complication and the hospital would have additional costs of $660.000.
It is reported that the use of external chest supports can decrease the incidence of deep sternal wound infections more than 6 times, so if a hospital with 300 surgeries decides to use them, only 2 patients would get this complication with additional costs for the hospital of $120.000.
The return on investment in external chest supports is significant.
When performing 300 cases a hospital would save $540.000, less the costs of the sternum support devices which on average are around $100. The total return on investment would be more than $500.000.
This calculation does not take into account the additional savings in decreased medication for pain, and treatment of pulmonary complications.
Invest in your patients wellbeing, advance recovery and save costs!"