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Physiotherapy treatment options in patients with unstable chest wall after cardiac surgery
KUBEŠOVÁ, Alžběta
This bachelor's thesis talks about complications after cardiac surgery, particularly unstable chest wall. The thesis describes what kind of complications occur in wound healing disorder and what kind of risk factors are connected to wound healing disorder. There are many precautionary measures that help to prevent the development of unwanted wound healing disorders. It is more than desired to treat patients with unstable chest wall using physiotherapy methods, as it shows the patient how to manage the wound, it helps with expectorating and increases the quality of life. The aim of the thesis is to describe physiotherapy treatment options and utilise them during the treatment sessions with patients. Theoretical part of my bachelor´s thesis is focused on sternotomy and it's healing, risk factors which represent higher possibility for development of postoperative complications and unstable chest wall. Thesis also talks about the current situation of postoperative complications and what are the possibilities of curing them. The text also talks about physiotherapy treatment options. The end of theoretical part describes different types of respiratory trainers. Some of them are therapeutical, some of them are diagnostic. It allows us to measure the strength of breathing muscles. The research part is carried out in the form of qualitative research, specifically as a case report method using two probanders with unstable chest walls after cardiac surgery conducted through median sternotomy. The patients were hospitalized in the cardiothoracic unit in Nemocnice České Budějovice, a.s. Each proband was thoroughly examined, a kinesiological analysis was carried out and physiotherapy treatment started. Each proband was treated for a different time period, because their sternotomy wound healed in different pace. The positive effect of the therapy and the resulting profits for patients with unstable chest walls was recognised because of measurement of chest development by tailoring meter, measurement of breath strength using MicroRPM and by subjective sensations of the probands.
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Nutritional status in patients suffering from deep sternal wound infection
Štroblová, Petra ; Špaček, Miroslav (advisor) ; Zlatohlávek, Lukáš (referee)
Introduction: The procedure of longitudinal median sternotomy is the most commonly used approach in cardiac surgery with the necessary complex postoperative treatment. A multifactorial approach is particularly important to prevent later complications, which can be very serious or fatal. The theoretical part of the thesis is not just about the risk factors that may interfere with the healing process but also about nutritional measures that could reduce the risk or completely prevent the profound dehiscence of the sternotomic wound. Methodology: The research method consisted of a retrospective analysis of the risk factors of deep sternal dehiscence in 22 patients who underwent cardiac surgery using the technique of longitudinal median sternotomy over a ten-year interval. 11 patients with sternal healing disorder were selected and included in group 1. Subsequently, an additional 11 patients were selected without sternal dehiscence. These patients were selected in such a way that their characteristics corresponded to the characteristics of patients of the first group in terms of statistical evaluation and comparison of both groups (type of exercise, length of operation, use of extracorporeal circulation, LIMA / BIMA, etc.). In the selection of patients in the control group 2, the laboratory nutrition...
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