ABSTRACT
PURPOSE: This study was conducted to evaluate the practicability, effectiveness, and potential complications of a newly improvised pocket-sized Heimlich valve named the Pneumostat (Atrium Medical Corp, Hudson, NH). DESCRIPTION: This was a retrospective review of 98 patients who underwent bullae resection after recurrent spontaneous pneumothorax at our center from January 2002 until June 2007. Data from the patients' files were collected and analyzed. EVALUATION: The mean age of the patients was 28.5 years (range, 17 to 52). There were 80.6% smokers and 5.1% diabetics. Pneumostat (Atrium Medical Corp) was inserted and the patients started to ambulate on day 1 after surgery. The mean hospital stay was 3.08 days. The mean duration of the affected lung to fully expand and the drain to be removed was 7.5 days. No other complications occurred, apart from drain site wound infection in 4.1% of the patients, which resolved with oral antibiotics and simple wound care. CONCLUSIONS: This review proved that the pocket-sized Pneumostat was safe and practical in this group of patients. It improved the patients' recovery in terms of mobilization and reduced the length of hospital stays with no significant complications.
Subject(s)
Blister/surgery , Chest Tubes , Drainage/instrumentation , Lung Diseases/surgery , Pneumothorax/surgery , Postoperative Complications/therapy , Adolescent , Adult , Equipment Design , Humans , Male , Middle Aged , Recurrence , Reoperation , Retrospective Studies , Rupture, Spontaneous , Thoracoscopy , Thoracotomy , Young AdultABSTRACT
BACKGROUND: Hypertrophic scarring caused by sternotomy is prevalent among Asians. The effectiveness of silicone gel in scar prevention may influence the decision of surgeons and patients regarding its routine use during the postoperative period. METHODS: The authors conducted a randomized, placebo-controlled, double-blind, prospective clinical trial. The susceptibility to scar development varied among patients; therefore, sternal wounds were divided into the upper half and the lower half. Two types of coded gel prepared by an independent pharmacist were used on either half. Thus, selection and assessment biases and confounders were eliminated. RESULTS: One hundred wounds in 50 patients were randomized into two arms, 50 control and 50 silicone gels. The median age was 61 years and there were 34 men and 16 women. Ethnic distribution was 28 Malays, 18 Chinese, and four Indians. No side effect caused by the silicone gel was noted. Ninety-eight percent of patients had moderate to good compliance. The incidence of sternotomy scar was 94 percent. At the third month postoperatively, the silicone gel wounds were scored lower when compared with the control wounds. The differences were statistically significant in all parameters, including pigmentation (p = 0.02), vascularity (p = 0.001), pliability (p = 0.001), height (p = 0.001), pain (p = 0.001), and itchiness (p = 0.02). CONCLUSIONS: The effect of silicone gel in prevention of hypertrophic scar development in sternotomy wounds is promising. There are no side effects and patients' compliance is satisfactory. This study may popularize the use of silicone gel in all types of surgery to minimize the formation of hypertrophic scars in the early postoperative period.
