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Related Concept Videos

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Airway management is a key skill in emergency and critical care settings, as maintaining a clear airway is essential for adequate oxygenation and ventilation.Head Tilt-Chin Lift TechniqueThe head tilt-chin lift maneuver is an essential technique primarily used in patients without suspected cervical spine injuries. To perform this maneuver, one hand is placed on the patient’s forehead, and gentle pressure is applied backward to tilt the head. The fingertips of the other hand are positioned...
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Managing flail chest, a condition characterized by a segment of the chest wall moving independently from the rest of the thoracic cage, requires a comprehensive approach. It includes a thorough assessment of the patient's condition, a diagnostic evaluation to determine the extent of the injury, and the implementation of appropriate medical interventions tailored to the individual's needs.
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Tracheostomy care is an essential nursing skill that involves cleaning and maintaining a tracheostomy tube to prevent infection and other complications. Here's a step-by-step guide explaining each procedure with its rationale. Note that disposable gloves are to be worn at all times and changed as often as needed to maintain a sterile work environment, and to protect both patient and healthcare worker.
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A tracheostomy is a surgical technique that involves making an incision in the neck to provide access to the trachea. It is frequently used in medical conditions such as airway obstruction and prolonged mechanical ventilation. Effective nursing management is crucial for the long-term success of a tracheostomy.
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Updated: Jul 11, 2025

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Sternal protection technique for open chest management.

Robert Pruna-Guillen1, Ignacio Morales-Rey1, Eduard Quintana1

  • 1Department of Cardiovascular Surgery, Institut Cardiovascular, Hospital Clìnic, 170th Villarroel St., 08036 Barcelona, Spain.

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|November 3, 2023
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Summary

A novel technique protects the sternum during open-chest management and delayed closure, mitigating bleeding and right ventricular injury. This method uses bypass tubing or drains for sternal margin protection, enhancing patient safety.

Keywords:
Open chest managementOperative bleedingRight ventricular protectionSternal protection technique

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Area of Science:

  • Cardiovascular Surgery
  • Thoracic Surgery
  • Surgical Innovation

Background:

  • Open-chest management with delayed sternal closure is necessitated by postoperative mediastinal bleeding or right ventricular failure.
  • Sternal bleeding, from medullar bleeding or bone margin oozing, presents a significant postoperative challenge.
  • Erosion of sternal margins can lead to right ventricular anterior wall injury in open-chest scenarios.

Discussion:

  • A simple yet effective sternal protection technique is proposed for open-chest management and delayed sternal closure.
  • The technique involves covering sternal margins with cardiopulmonary bypass tubing or mediastinal drains, secured by sutures.
  • This approach aims to control sternal bleeding and prevent right ventricular injury.

Key Insights:

  • Utilizing readily available materials like bypass tubing or drains offers a cost-effective solution.
  • Application of a thrombin-derived hemostatic agent can be employed for enhanced hemostasis in cases of profuse bleeding.
  • Vacuum sealing achieved with a latex membrane and sterile adhesive sheets provides wound isolation and protection.

Outlook:

  • This technique offers a valuable addition to the surgical armamentarium for managing complex open-chest cases.
  • Further studies could evaluate the long-term efficacy and complication rates associated with this sternal protection method.
  • Wider adoption could improve outcomes for patients requiring delayed sternal closure.