Posthorax Studies
Posthorax is the only product of its kind to be tested in significant non-industry funded clinical trials. After more than 12,000 patients included, the results speak for themselves. Below is the full scientific literature. If you have any questions at all don't hesitate to contact us.
Can a prophylactic device save thousands per patient?
GENERATE SUBSTANTIAL COST SAVINGS
Significantly reduce incidence of surgical site infections
Surgical site infections are some of the most expensive complications after cardiac surgery. They prolong patients hospital stay, require costly antibiotic medications, increase materials used for wound dressing, require additional surgical procedures and sometimes vacuum therapy, as well as increased human resources for patient care. All of the above create a massive amount of additional costs. Prophylactic use of the Posthorax sternum support vest has shown to reduce the incidence of infections by up to 76% (https://www.ncbi.nlm.nih.gov/pubmed/30903177)
Reduce sternal complications
Bone-non-union warrants increased intake of pain medication, consequently slows down the healing process and increases the risk of infection. It could mean an exponential increase in treatment costs. Breaking of wires or wires cutting into the bone can require re-operation. Tension exerted to the sternum wound can cause dehiscence especially for high risk patients such as obesity, smokers or diabetics. These can incur additional costs for treatment. Prevention requires reduction of stress around the wound edges. The Posthorax sternum support vest relieves any potential tension created on the wound.
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1. Multicenter Prospective Randomized Clinical Trial, Vienna,Hamburg-Eppendorf, NümbergM. Gorlitzer, F.Wagner, S. Pfeiffer
2. Cohort Study - University HamburgH. Reichenspurner
3. Cohort Study - Karolinska University StockholmH. Jonsson
4. Cohort Study - Karolinska University StockholmM. Albert, R. Nagib, A. Ursulescu, U. F.W. Franke
5. Cohort Study - University Hospital Southampton NHSN. Nikolaidis, C. Barlow
6. Cohort Study - University ZurichH. Loeblein, M. Genoni
7. Cohort Study, University Hospital MainzK. Buschmann, J. Bienias, L. Brendel, A. Ghazy, I Karliova, A.L. Emrich, C.F. Vahl
PUBLICATIONS
1. A Randomized Trial to Assess the Contribution of a Novel Thorax Support Vest (Corset) in Preventing Mechanical Complications of Median Sternotomy
Philippe P. Caimmi. Maurizio Sabbatini. Emmanouil I. Kapetanakis. Silvia Cantone. Marcus V. Ferraz. Mario Cannas. Ugo F. Tesler
Received: November 1, 2016
© The Author(s) 2016. This article is published with open access at Springerlink.com
2. Do external support devices reduce sternal wound complications after cardiac surgery?
Interactive CardioVascular and Thoracic Surgery Advance Access published August 30, 2016
📁 A.Modi_Royal_Sussex_County_Hospital_Brighton_UK
3. Prevention of sternal wound complications after sternotomy: results of a large prospective randomized multicentre trial
Michael Gorlitzer, Florian Wagner, Steffen Pfeiffer, Sandra Folkmann, Johann Meinhart, Theodor Fischlein, Hermann Reichenspurner and Martin Grabenwoeger
Corresponding author. Hietzing Hospital, Wolkersbergenstr. 1, 1130 Vienna, Austria. Tel: +43-1-80110; fax: +43-1-80110-2729; e-mail: michael.gorlitzer@wienkav.at (M. Gorlitzer). Received 17 October 2012; received in revised form 22 April 2013; accepted 29 April 2013
4. Interactive CardioVascular and Thoracic Surgery
A prospective randomized multicenter trial shows improvement of sternum related complications in cardiac surgery with the Posthorax ® support vest Michael Gorlitzer, Florian Wagner, Steffen Pfeiffer, Sandra Folkmann, Johann Meinhart, Theodor Fischlein, Hermann Reichenspurner and Martin Grabenwöger
Interact CardioVasc Thorac Surg 2010;10:714-718; originally published online Jan 26, 2010;
5. A newly designed thorax support vest prevents sternum instability after median sternotomy
European Journal of Cardio-thoracic Surgery 36 (2009) 335—339
POSTHORAX STERNUM SUPPORT
STUDIES 2008-2016
1. Biomechanical Pressure Sensor Testing
Institut for Biomechanical Engineering University Vienna, Prof. Dr. Bijak
Result: Posthorax produced 8 NM counter pressure – the flexible bandage only 2 NM : -75%
2. Multicenter Prospective Randomized Clinical Trial
Multicenter study, prospective randomized (2600 patients) Heartcenter Hietzing/Vienna, University Hospital Hamburg - Eppendorf, Heartcenter Nürnberg
Result: Reduction mediastinitis from 2,27 % to 1,04 % : -54% (mediastinitis classification El Oakley and Wright)
📁 DGTHG_2011_slides_E Papers: EJCTS_Paper_2009 ICVTS_paper_2010 ICVTS_paper_2013
3. Cohort Study University Heartcenter Hamburg
including all patients (2200) comparing 2011-2012
Result: Reduction of mediastinitis from 2,39 % to 0,88 % : -63% (mediastinitis classification El Oakley and Wright)
4. Karolinska University Hospital Stockholm
Cohort study 978 patients 2011-2012
Result: Reduction mediastinitis from 2,2% to 0,6% : -72%
📁 Karolinska Sternum Instability in Clinical practice
5. University Hospital Southampton NHS
Risk-adjusted study of 265 patients 2011-2012
Result: Reduction DSWI from 2,1 % to 1,2 % : -43%
Indication prophylactic use: BMI >30, diabetes, steroids, Re-OP, reduced lung function, osteoporosis. Therapeutic use: clicky sternum, severe cough, SWI, Delirium/agitation, DSWC (on Vac pump or post rewiring)
Nomination HSJ Efficiency Awards 2013
📁 First UK Experience Southampton General Hospital 2012
6. University Heartcenter Zurich, Switzerland
Retrospective 1689 patients 2010-2012
Result: Reduction DSWI from 3,2% to 1,5% : -52%
Papers:
📁 Perioperative Management and Strategies to Decrease Sternal Wound Infection (Presented at 27th EACTS Annual Meeting, Vienna, Austria, 5 - 9 October 2013)
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Abstract (Review): 📁 Perioperative Management and Strategies to Decrease Sternal Wound Infection
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Presentation: 📁 Sternum Infect 1BIMA
7. Clinica Del Lavoro e Delle Riabilitazione Milano, Italy
Respiratory study, prospective randomized 80 patients. Testing of cardiopulmonary % VO2, Plethysmograph TLC%, DLCO%, KCO%, 6 min walking, EuroQoL 5D-3L.
Result: No significant differences in the groups with and without vest
📁 Presentazione ANMCO definitiva EN (English)
📁 Presentazione ANMCO definitiva IT (Italian)
8. Karolinska University Hospital Stockholm
There are several mechanisms by which the vest could affect respiration. Breathing while wearing the vest may be more dependent on the diaphragm, shifting ventilation to the lower lobes.
This may prevent atelectasis of the lower lobes, where it has been shown to occur most frequently following surgery (17). Movement of the ribcage after sternotomy may be painful, as this can cause movement of the two halves of the sternum. Such pain has been well documented and may persist for years (22,30). Because the vest restricts expansion and movement of the ribcage, breathing while wearing the vest may be less painful for the wearer.
This may increase the effectiveness of chest physiotherapy, including deep breathing exercises, and may facilitate early mobilization. This, in turn, may lead to deeper respiration when using the vest, with improved ventilation of the lungs leading to a lower occurrence of atelectasis.
Papers:
📁 STERNUM SUPPORT MAY PREVENT MAJOR ATELECTASIS AFTER MEDIAN STERNOTOMY
9. University Hospital of Novara 'Maggiore della Caritá'
Mechanical complications of median sternotomy may cause significant morbidity and mortality in cardiac surgical patients. This study was aimed at assessing the role of Posthorax support vest in the prevention of sternal complications and the improvement of anatomical healing in patients at high risk for mechanical dehiscence after cardiac surgery by mean of median sternotomy.
10. Cohort Study, University Hospital Mainz
OBESE CARDIAC PATIENTS: SIGNIFICANT REDUCTION OF DEEP STERNAL WOUND COMPLICATIONS BY WEARING THE POSTHORAX VEST?
Buschmann K., Bienias J., Brendel L., Halbroth I., Ghazy A., Karliova I., Emrich A.L., Vahl C.F.
Universitätsmedizin Mainz, Herz-, Thorax-, Gefäßchirurgie, Mainz, Germany
Objectives:
Sternal wound healing disturbances are still a frequently postoperative complication after median sternotomy especially in obese patients. Surgical wound revision and prolonged hospitalization increase the costs disproportionally. Thus we planned a study to evaluate if the sternal wound complication rate after cardiac surgery can be profitably reduced by wearing the PosthoraxTM vest.
Conclusion:
The rate of deep sternal wound complication in the Vest group tells its own tale. There is a reduction of half as less. As limitation we have to ask if the Vest group is compareable to the Control group because of significant shorter ICU stay and earlier mobilization, but otherwise these factors belong to postoperative course without complications. Of course the surgical technique for wound closing is also important and dependent on the surgeon. Nevertheless in our clinic we apply the Posthorax vest in every obese patient who has to underwent cardiac surgery via median sternotomy in order to reduce postoperative deep sternal wound complications and costs.
11. Robert - Bosch - Hospital Stuttgart, Germany
THE TOTAL ARTERIAL MYOCARDIAL REVASCULARIZATION USING BILATERAL IMA AND THE ROLE OF POST-OPERATIVE STERNAL STABILIZATION TO REDUCE WOUND INFECTIONS IN A LARGE COHORT STUDY.
Albert M, MD Ursulescu A, MD Franke UFW, MD Robert-Bosch-Hospital, Stuttgart, Germany
Objectives:
The total-arterial myocardial revascularization using bilateral IMA shows improved results regarding mortality, long-term survival as well as superior graft patency and thus has become the standard technique according to recent guidelines. On the other hand, those patients might suffer from an increased risk of developing sternal wound infections, especially when being obese or having a medical history of diabetes. One reason for the wound complications may be an early sternum instability, which could be avoided using a thorax support vest (e.g. Posthorax vest). This retrospective study compares the wound complications after bilateral IMA grafting according to the use of a Posthorax vest.
Conclusion:
As seen in this retrospective study, the early perioperative use of a thorax stabilization vest such as the POSTORAX vest can reduce the incidence of sternal wound complications significantly. Furthermore when a wound infection occurred and the patients returned to hospital for wound revision, the patients who had been administered the POSTORAX vest postoperatively will have a significant shorter length of stay until wound closure.
Papers:
📁 The total arterial myocardial revascularization using bilateral IMA and the role of post-operative sternal stabilization to reduce wound infections in a large cohort study. 📁 Presentation
12. Royal Sussex County Hospital, Brighton, UK
Early post-sternotomy use of the available external non-elastic sternal support devices reduces sternal wound complications and may be associated with a shorter length of hospital stay.
Papers:
📁 Do external support devices reduce sternal wound complications after cardiac surgery?