Abstract
BACKGROUND: After midline sternotomy patients are instructed on activity precautions to avoid sternal wound complications. We questioned how restrictive these precautions must be, since they can lead to a postoperative decrease in quality of life. AIMS: To identify mechanical stress factors causing sternal instability and infection in order to create evidence based guidelines for activity following sternotomy. METHODS: Literature review. RESULTS: No evidence was found to support weight limitation regarding activity, as long as the upper arms are kept close to the body and activity is within a pain-free range. Recommendations: Avoid stretching both arms backwards at the same time (10days); loaded activities should be done with the elbows close to the body (eight weeks); only move arms within a pain-free range; use leg rolling with counterweighing when getting in and out of bed; when coughing cross the arms in a "self-hugging" posture; supportive bra or vest is recommended when breast cup>/=D, body mass index>/=35 or frequent cough. CONCLUSION: This study provides insights into mechanical stress factors acting upon sternum and the overlying skin. Recommendations on activity precautions based on these finding have a patient supportive approach focusing on possibilities and not restrictions.
Original language | English |
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Journal | European Journal of Cardiovascular Nursing |
Volume | 9 |
Pages (from-to) | 77-84 |
Number of pages | 8 |
ISSN | 1474-5151 |
DOIs | |
Publication status | Published - 2010 |
Externally published | Yes |