Journal of Korean Critical Care Nursing (중환자간호학회지)

Korean Society of Critical Care Nursing (한국중환자간호학회)
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Relationship between Lateral Position Change and Sternal Complications after Cardiac Surgery through Median Sternotomy

정중 흉골 절개술을 이용한 심장수술 후 환자의 체위변경과 흉골 합병증 발생과의 관계

  • Kang, Young Ae (Cardiovascular Surgery ICU, Asan Medical Center) ;
  • Bae, Su Jin (Cardiovascular Surgery ICU, Asan Medical Center) ;
  • Song, Chie Eun (Cardiovascular Surgery ICU, Asan Medical Center)
  • 강영애 (서울아산병원 흉부외과 중환자실) ;
  • 배수진 (서울아산병원 흉부외과 중환자실) ;
  • 송치은 (서울아산병원 흉부외과 중환자실)
  • Received : 2016.02.24
  • Accepted : 2016.05.23
  • Published : 2016.06.30
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Abstract

Purpose: This study was conducted to examine the relationship between lateral position change and sternal complications after cardiac surgery through median sternotomy. Methods: This study was a retrospective descriptive case-control study, involving 241 patients who underwent cardiac surgery through median sternotomy. Data from October 2011 to September 2014 were collected. Results: Sternal complications (i.e. dehiscence, sternal instability, mediastinitis) developed in 33 patients (13.7%). Primary symptoms of complications were discharge and erythema, and the mean time difference from surgery to appearance of symptoms was 15 days (range, 1-138 days). The factors associated with sternal complications were cancer comorbidity (${\chi}^2=5.22$, p=.039), internal mammary artery procedure (${\chi}^2=4.16$, p=.041), and duration of extra-corporeal membrane oxygenation (p=.033). Position change was not related to incidence of sternal complications (${\chi}^2=0.14$, p=.704). Pressure ulcers appeared in 63 patients (26.1%). Mean time difference from surgery until occurrence of ulcers was 6.7 hours (range, 0-323.0 hours), but position change was started from 132.4 hours (range, 27.1-503.2 hours) after intensive care unit admission. Conclusions: These results provide baseline data to create a standard position change and activity protocol for patients after median sternotomy. Furthermore, the study could help clinical practitioners establish evidence-based nursing practices.

Keywords

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