Specifics of using thoracic bandage after cardiac surgery via sternotomy and its impact on reducing pain during therapeutic exercises

Abstract

Purpose: to investigate specifics of using thoracic bandage after cardiac surgery via sternotomy and its impact on reducing pain during therapeutic exercises. In order to study specifics of using a postoperative thoracic bandage on the seventh postoperative day patients (n=252) were asked two questions about the force of thorax compression exerted by the bandage. As soon as the questions were answered, the degree of thoracic bandage tension was also assessed by a physical therapist. Thereafter, some patients (n=44; who did not take painkillers within 12 hours before the examination) assessed pain on a numeric rating scale (10 points – maximum pain, 0 points – no pain) as follows: at rest, when coughing and moving their upper extremities (arms forward, sideward, upward), when wearing a bandage with and without a load (dumbbells 1 and 2 kg for each arm); then all points of the scale were assessed without wearing a thoracic bandage. Most of the patients noted that the bandage exerted light compression (184 patients) and did not restrict deep breathing (220 patients). The evaluation performed by a physical therapist found that a thoracic bandage had only a slight degree of tension in most of the patients (194 patients or 76.98%), since it was easy to slip the hand between the patient’s back and the bandage, stretching the latter with minimal effort. The use of a thoracic bandage had no impact on the pain when patients moved their upper extremities. The obtained pain rates were very low. The highest pain rates were obtained during coughing. When moving arms the level of pain did not change statistically as compared with the state of rest. Arm position and load increase within specific limits had no impact on pain level. The use of a postoperative thoracic bandage is characterized by its mild tension, which does not limit deep breathing and, consequently, cannot limit the increase of chest circumference during dehiscence. The assessment of tension performed by physical therapists was consistent with the patients’ responses. The use of a bandage did not reduce the level of pain when patients moved their upper extremities and coughed.