Impact of musculoskeletal disorders in patients using orthopedic equipment on sternotomy wound healing after cardiac surgery — preliminary report
, 2, 2, 2, 3, 45, 6, 7, 12
Abstract
Background: The presence of locomotive disorders may negatively impact the outcome of cardiac surgeries. This retrospective study aimed to assess the effect of preoperative diagnosis of locomotive disorders requiring the continuous use of orthopedic devices on postoperative rehabilitation and stable sternum adhesion.
Material and methods: The study included 122 patients who underwent cardiac surgery, with 68 patients in the study group having a musculoskeletal disorder and 54 patients in the control group without such disorders. Preoperative demographic, clinical, and laboratory data as well as postoperative rehabilitation and sternum adhesion were evaluated.
Results: The results showed that patients in the study group had lower levels of calcium (p < 0.001), vitamin D (p < 0.001), and creatine kinase (p = 0.022) prior to the surgery. In the early postoperative period, 8 patients from the study group and 4 from the control group required reoperation due to sternal instability (p = ns). In the late postoperative period, sternal instability was present in 2 patients from the study group and 3 from the control group (p = ns). The survey study revealed a significantly better (p = 0.029) evaluation of postoperative rehabilitation among the study group patients.
Conclusions: Overall, the results indicated that a preoperative locomotive disorder has no significant impact on sternal instability in the early or late postoperative periods. However, patients with such disorders have a better understanding of the importance, purpose, and course of rehabilitation after cardiac surgery and exhibit lower levels of calcium, vitamin D, and creatinine.
Keywords: Musculoskeletal disorderscardiac surgerysternotomycomplications
References
- Carrel A, Hartmann A. CICATRIZATION OF WOUNDS. J Exp Med. 1916; 24(5): 429–450.
- Mitnitski AB, Graham JE, Mogilner AJ, et al. Frailty, fitness and late-life mortality in relation to chronological and biological age. BMC Geriatr. 2002; 2: 1.
- Merke J, Milde P, Lewicka S, et al. Identification and regulation of 1,25-dihydroxyvitamin D3 receptor activity and biosynthesis of 1,25-dihydroxyvitamin D3. Studies in cultured bovine aortic endothelial cells and human dermal capillaries. J Clin Invest. 1989; 83(6): 1903–1915.
- Li YC, Kong J, Wei M, et al. 1,25-Dihydroxyvitamin D(3) is a negative endocrine regulator of the renin-angiotensin system. J Clin Invest. 2002; 110(2): 229–238.
- Ye C, Xu M, Wang S, et al. Decreased Bone Mineral Density Is an Independent Predictor for the Development of Atherosclerosis: A Systematic Review and Meta-Analysis. PLoS One. 2016; 11(5): e0154740.
- Kawecka E, Rozentryt P, Niedziela J, et al. NIEWYDOLNOŚĆ SERCA Osteoporoza i osteopenia u chorych z niewydolnością serca. Kardiologia Oparta na Faktach. 2010; 2: 161–6.
- Zapolski T, Kornecki W, Wysokiński A. Osteoporoza a choroby układu sercowo-naczyniowego. Choroby Serca i Naczyń. 2017; 14(5): 263–73.
- Balachandran S, Lee A, Denehy L, et al. Risk Factors for Sternal Complications After Cardiac Operations: A Systematic Review. Ann Thorac Surg. 2016; 102(6): 2109–2117.
- Phoon PH, Hwang NC. Deep Sternal Wound Infection: Diagnosis, Treatment and Prevention. J Cardiothorac Vasc Anesth. 2020; 34(6): 1602–1613.
- Juhl AA, Hody S, Videbaek TS, et al. Deep Sternal Wound Infection after Open-Heart Surgery: A 13-Year Single Institution Analysis. Ann Thorac Cardiovasc Surg. 2017; 23(2): 76–82.
- Życzkowska J, Grądalski T. Zespół słabości (frailty) : co powinien o nim wiedzieć onkolog? Onkologia w Praktyce Klinicznej. 2010; 6(2): 79–84.
- Gabryś T, Bajorek A, Malinowska-Lipień I. Zespół słabości – zasadniczy problem zdrowotny osób starszych. Część I. Gerontologia Polska. 2015; 1: 29–33.
- Young J. Red flags in geriatrics: diagnoses not to be missed in acute units. Clinical Medicine. 2007; 7(5): 512–514.
- Chen X, Mao G, Leng SX. Frailty syndrome: an overview. Clin Interv Aging. 2014; 9: 433–441.
- Kerr R, Newsome P, Germain L, et al. Effects of acute liver injury on blood coagulation. J Thromb Haemost. 2003; 1(4): 754–759.
- Deschka H, Erler S, El-Ayoubi L, et al. Suction-irrigation drainage: an underestimated therapeutic option for surgical treatment of deep sternal wound infections. Interact Cardiovasc Thorac Surg. 2013; 17(1): 85–89.
- Strandberg TE, Pitkälä KH. Frailty in elderly people. Lancet. 2007; 369(9570): 1328–1329.
- Ferrucci L, Cavazzini C, Corsi A, et al. Biomarkers of frailty in older persons. J Endocrinol Invest. 2002; 25(10 Suppl): 10–15.
- Sokołowski R, Ciesielska N, Czajkowska A, et al. Patogeneza zespołu kruchości. Journal of Health Sciences. 2014; 4(9): 197–204.
