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Journal of Korean Critical Care Nursing 2016;9(1):66-76.
Published online June 30, 2016.

정중 흉골 절개술을 이용한 심장수술 후 환자의 체위변경과 흉골 합병증 발생과의 관계
강영애, 배수진, 송치은
1서울아산병원 흉부외과 중환자실
2서울아산병원 흉부외과 중환자실
3서울아산병원 흉부외과 중환자실
Relationship between Lateral Position Change and Sternal Complications after Cardiac Surgery through Median Sternotomy
Young Ae Kang, Su Jin Bae, Chie Eun Song
1Cardiovascular Surgery ICU, Asan Medical Center
2Cardiovascular Surgery ICU, Asan Medical Center
3Cardiovascular Surgery ICU, Asan Medical Center
This study was conducted to examine the relationship between lateral position change and sternal complications after cardiac surgery through median sternotomy.
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.
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.
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.
Key Words: Sternal complications, Position change, Median sternotomy, Cardiac surgery
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