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Related Concept Videos

Flail Chest-II01:26

Flail Chest-II

528
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.
Assessment:
1. Clinical Evaluation:
History:
528

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Related Experiment Video

Updated: Jan 16, 2026

Donor Posterior Atrial Flap Rotation for Left Atrial Cuff Reconstruction in Lung Transplantation
07:28

Donor Posterior Atrial Flap Rotation for Left Atrial Cuff Reconstruction in Lung Transplantation

Published on: October 11, 2024

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Reducing Upper Extremity Precautions After Lung Transplant: The Clamshell Protocol Pilot Study.

Haley Bento1, Deborah Slay1,2, Maxwell Hunter3

  • 1Department of Physical Therapy and Athletic Training, University of Utah, Salt Lake City, UT.

Cardiopulmonary Physical Therapy Journal
|October 6, 2025
PubMed
Summary
This summary is machine-generated.

A new clamshell precaution (CP) protocol for upper extremity (UE) movement after lung transplantation (LTx) showed fewer adverse events than the traditional sternal precaution (SP) protocol. This suggests reduced UE movement restrictions may be a safe alternative for LTx patients.

Keywords:
clamshell incisionlung transplantsurgical precautions

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Area of Science:

  • Cardiovascular Surgery
  • Thoracic Surgery
  • Transplantation Medicine

Background:

  • Traditional sternal precaution (SP) protocols for post-lung transplantation (LTx) limit upper extremity (UE) movement.
  • A less restrictive clamshell precaution (CP) protocol was implemented as an alternative.

Purpose of the Study:

  • To assess the safety of transitioning from SP to CP protocols in LTx patients.
  • To evaluate adverse events (AEs) associated with reduced UE movement restrictions.

Main Methods:

  • Single-site, observational, cohort pilot study (March 2021-February 2023).
  • Compared AEs (sternal instability, wound infection) within 6 months post-LTx between SP (n=16) and CP (n=24) cohorts.
  • Safety defined by AE frequency and 95% Wilson score confidence intervals (CIs).

Main Results:

  • Demographics and clinical characteristics were similar between cohorts.
  • AEs occurred in 10% of patients: 18.8% in the SP cohort vs. 4.2% in the CP cohort.
  • Patients with AEs were older with higher BMI and comorbidity scores.

Conclusions:

  • Preliminary evidence suggests the CP protocol may be associated with fewer AEs compared to SP.
  • Reducing UE movement restrictions post-LTx appears to be a safe alternative.
  • Further studies are needed due to small sample sizes to confirm CP protocol safety.