정중 흉골 절개술을 이용한 심장수술 후 환자의 체위변경과 흉골 합병증 발생과의 관계. (Korean)

Relationship between Lateral Position Change and Sternal Complications after Cardiac Surgery through Median Sternotomy. (English)

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 (X²=5.22, p =.039), internal mammary artery procedure (X²=4.16, p =.041), and duration of extra-corporeal membrane oxygenation ( p =.033). Position change was not related to incidence of sternal complications (X²=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. [ABSTRACT FROM AUTHOR]

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