Pre and post operative care in the new surgical treatment of the Pectus Excavatum: Pectus Up

Innovative surgical method that offers a very minimally invasive solution to the treatment of Pectus Excavatum

Preparation for surgery with Pectus Up

There are some aspects that must be taken into account before the patient receives surgical treatment for Pectus Excavatum. As in any surgical intervention with anesthesia, this operation carries certain risks, which your surgeon will duly explain to you. It is also necessary to take into account some warnings, of which we highlight the following two:

  • You must inform the surgeon of the medications that you are taking since some of them could interfere with anesthesia or cause complications. Drugs such as aspirin or ibuprofen can cause bleeding.
  • Tobacco contributes to the development of lung and heart problems, among others. It also hinders wound healing. Tissues require oxygen for proper healing and tobacco significantly reduces the amount that reaches them.
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Post-operative care after the intervention

POST-OPERATIVE CARE AND SUPERVISION

Postoperative care and supervision are important when the patient has undergone surgical treatment of Pectus Excavatum.

Precautions after surgery

  • Care should be taken with personal hygiene to avoid possible infections.
  • The wound may not be touched or wet. In addition, the dressing should not be lifted until the first check-up by the surgeon.
  • It is not advisable to spend a long time in a decubitus position (lying down).
  • It is advisable to sleep on your back and avoid being on your side during sleep (at least during the first 3 months).
  • Anomalous or rigid positions should not be adopted, which a priori may avoid pain, but which may have consequences related to the bad position.
  • You must maintain a good trunk position and avoid exposing yourself to risky situations.
  • Avoid environments with crowds of people, violent physical contact and exposure to risk situations.
  • Absolute rest for about a week after the intervention

If in doubt, follow the surgeon’s criteria.

Activities after surgery

It should be noted that metal fixation devices or thoracic implants are generally not capable of withstanding activity levels or loads tolerated by a normal, healthy chest wall.

In case of not following the instructions recommended by the surgeon, the Pectus Up can loosen, move or come off and, if the chest is also subjected to bearing weights or loads, or to very intense activities, or if the patient suffers traumatic injuries in the chest.

Activities which might be performed will always depend on the evolution of each patient and the recommendations of the surgeon. In general, the recommendations are as follows:

  • Perform gentle breathing exercises on a daily basis during the first fifteen days of the intervention, such as gently inspiring until the chest is completely filled; then exhale slowly until the lung is empty of air.
  • You can move and raise your arms gradually, acclimatizing to the new situation successively and continuously, without causing pain.
  • Relative rest during the first month. This will consist of gradually resuming activities of daily living, maintaining good trunk posture, avoiding movements that cause pain.
  • Avoid twisting your torso and lifting weights during this first month.
  • You can go to school, university or your usual job after the first check-up with the surgeon, if the surgeon considers it appropriate and the patient feels well.
  • Resume sports activity three months after the intervention.
  • Refrain from sports that involve extensive movement of the torso such as golf, swimming (basically backstroke and breaststroke), tennis, lifting weights such as bench presses, etc. ., for a period of six months.
  • Avoid all high-risk and contact sports. Contact sports are not recommended for at least the first six months after implantation. Severe trauma to the anterior chest can cause serious intrathoracic injury.
  • Avoid violent physical contact.

FAILURE TO FOLLOW POSTOPERATIVE INSTRUCTIONS MAY RESULT IN ADVERSE EFFECTS. SEE THE COMPLICATIONS SECTION

POSSIBLE ADVERSE EFFECTS AFTER THE INTERVENTION

Adverse effects that may appear after the operation are as follows:

  • The implant or any of its components can loosen, dislodge or break.
  • Reactions due to hypersensitivity to metals or allergic reaction to the implant material.
  • Pain, discomfort, or strange sensation due to the presence of the implanted device.
  • Skin irritation or wound infection.
  • Seroma.
  • General risks of surgery under general anesthesia (permanent injuries, death,…)
  • Incomplete or inadequate correction of the deformity or reappearance of the same, before or after removal of the implant.
  • Surgical trauma.
  • Pneumothorax in case of excessive perforation of the sternum.
  • Removal of the implant may be necessary if the patient experiences adverse effects due to one of the above.
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