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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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Healing of the surgical wound after cardiac surgery
Mrkvičková, Petra ; Gigalová, Veronika (advisor) ; Votroubková, Michaela (referee)
ANOTATION Autor: Petra Mrkvičková Institution: Charles University, Faculty of Medicine in Hradec Kralove, Department of Social Medicine, Division of Nursing Title: Healing of the surgical wound after cardiac surgery Supervisor: Mgr. Veronika Gigalová Number of pages: 136 Number of attachments: 8 Year of defense: 2019 Keywords: patient, cardiac surgery, sternotomy, healing of the surgical wound, nursing care The bachelor thesis deals with healing of surgical wound after cardiac surgery. Theoretical part of the thesis deals with facts from the area of cardiac surgery, the most common cardiac diseases, which are indicated for cardiac surgery and appropriate surgical approaches. It points out to risk groups of patients who may have complications within the healing wound. This thesis focuses mainly on nursing care of sternotomy with sternotomy healing and potential complications. It points out to the importance of regular inspection of sternotomy, regular changing of wound dressing under aseptic conditions, education and care of patients' mental health. In the empirical part, the thesis focuses on quantitative and qualitative research. Quantitative research was conducted by a non-standardized questionnaire and qualitative research by a semi-structured interview. The aim of the research was to find out some...
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Physiotherapy in patients after cardiac interventions
VÝBORNÁ, Markéta
In my thesis I tried to focus on the issue of physiotherapy and curative rehabilitation by the patients after cardio-surgical interventions during their stay in a hospital facility. In the opening part I am presenting a brief overview of used cardio-surgery techniques and accesses with their short evaluation. I dealt in brief with the issue of wound healing and the scar formation, including a summary of the most important post-operation complications and accesses, which enable to avoid these complications. One of partial tasks solved in my thesis was the search of physiotherapeutic techniques after the heart operations. Here I focused especially on modern and recently used strategies. I adduce their short definition and explanation of possible benefits resulting from their use. In the second part of my work I am directly evaluating the progress of physiotherapy of two patients with the identical diagnosis who were operated on by two different techniques. Both the patients were taken to the planned performance ? the exchange of the aortic valve as a consequence of their stenosis and present insufficiency at the cardio-surgical department of the hospital in České Budějovice. In one case the classical medial sternotomy was performed, in the other case it was decided to perform a mini-invasive intervention ? the right-side mini-thoracotomy. With both the observed patients the same exercise was practiced just from the first day of the physiotherapy. During the whole period the values of vital functions were carefully checked and registered. The physical and mental state of patients was also followed including the painfulness of the wound. I collected the data for my thesis by means of interviews with the physiotherapist and the patients participated in the observation. I also elaborated a detailed casuistic and analysis of patients? personal data. I cooperated actively with the present staff. The exercises were done twice a day, in the morning and in the afternoon. The whole rehabilitation unit lasted approximately 15 minutes each time. The exercise was started in the bed where simple mobilization exercises were done, some elements of the breath and vascular gymnastics and elements of Vojta?s reflexive locomotion. Gradual verticalization of the patient enabled us to use even more complicated exercises. The exercise was finished with a walk in the corridor and on the stairs. Some respiration aids were used, described in the following part. From the rehabilitation process, which was in progress on both the patients immediately from the first rehabilitation day, results clearly that the patient with medial sternotomy (a woman) showed a considerably greater painfulness every day, which was very limiting for her. Even her mental condition was worse. This patient was not able to perform with a delay of several days those exercises, practiced by the patient with the mini-invasive entry already without any troubles. Considerable differences were also found in the walking, both in the distance and in posture while walking.
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