Q What is involved in the general nursing care of the patient with an open sternum?
A Brandi L. Holcomb, DNP, APRN, AGACNP-BC, CCRN, replies:
In caring for a patient with an open chest after cardiotomy, the nurse must consider the various perioperative conditions that may require the sternum to be kept open. The literature contains few evidence-based articles or guidelines specifically addressing nursing care of the patient with an open chest after cardiotomy. However, more evidence-based guidance is available for the cardiac transplant and pediatric surgical populations.1 It is reasonable to incorporate these recommended practices into the care of the adult cardiac surgical patient with an open chest.
Open-chest management and delayed sternal closure are implemented after 1% to 4% of surgical procedures involving cardiotomy in the adult population and more frequently in the pediatric population.2 In order to care for these patients effectively, the intensive care...