Patient Attitudes to Sternotomy and Thoracotomy Scars

Crossland, David; Jackson, Sue; Lyall, Robert; Hamilton, J. R. L.; Hasan, Abdulkarim; Burn, John; O’Sullivan, John

doi:10.1055/s-2004-830422

Cited by 23 publications

(18 citation statements)

References 7 publications

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“…Furthermore, 40% of the SVCHD patients had permanent epicardial pacemakers placed, which often requires additional subxyphoid or anterior thoracotomy incisions that can cause further disfigurement to the chest area. The qualitative literature in the general CHD population supports the feelings of being “disfigured” or “dissatisfied” with their surgical scars and the need to conceal or hide them from others [7, 10–12]. Although the patient’s scar is a daily reminder of their heart condition, some have perceived their scars in a positive light as an appreciation of health [11].…”

Section: Discussionmentioning

confidence: 99%

“…In another study, the researchers found that psychological symptoms in male patients were strongly influenced by body-image perception, especially if they rejected their body as a result of disfigurement or a perceived deficiency [9]. Many adults with CHD were interviewed or surveyed about their experiences, attitudes, or impact of their surgical scar and reported feeling self-conscious or negative attitudes about their body and scars [7, 10–12]. However, no studies have been reported in patients with complex SVCHD that may result in more bodily disfigurement.…”

Section: Introductionmentioning

confidence: 99%

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Sex and Age Differences in Body-Image, Self-Esteem, and Body Mass Index in Adolescents and Adults After Single-Ventricle Palliation

et al. 2012

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Single-ventricle congenital heart disease (SVCHD) requires multiple palliative surgical procedures that leave visible surgical scars and physical deficits, which can alter body-image and self-esteem. This study aimed to compare sex and age differences in body-image, self-esteem, and body mass index (BMI) in adolescents and adults with SVCHD after surgical palliation with those of a healthy control group. Using a comparative, cross-sectional design, 54 adolescent and adult (26 male and 28 female) patients, age 15–50 years, with SVCHD were compared with 66 age-matched healthy controls. Body-image and self-esteem were measured using the Multidimensional Body-Self Relations Questionnaire–Appearance Scale and Rosenberg Self-Esteem Scale. Height and weight were collected from retrospective chart review, and BMI was calculated. Female adolescents and adult patients with SVCHD reported lower body image compared with males patients with SVCHD and healthy controls (p = 0.003). Specific areas of concern were face (p = 0.002), upper torso or chest (p = 0.002), and muscle tone (p = 0.001). Patients with SVCHD who were <21 years of age had lower body image compared with healthy controls (p = 0.006). Self-esteem was comparable for both patients with SVCHD and healthy peers. There were no sex differences in BMI; BMI was higher in subjects >21 years of age (p = 0.01). Despite the similarities observed in self-esteem between the two groups, female patients with SVCHD <21 years of age reported lower perceived body-image. Our findings support the need to recognize poor psychological adjustment related to low self-esteem in patients with SVCHD; female patients warrant increased scrutiny. Strategies to help patients with SVCHD cope with nonmodifiable aspects of body-image during the difficult adolescent–to–young adult years may potentially enhance self-esteem and decrease psychological distress.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Sex and Age Differences in Body-Image, Self-Esteem, and Body Mass Index in Adolescents and Adults After Single-Ventricle Palliation

et al. 2012

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“…438 Many patients are embarrassed by surgical scarring. 439 Among adults with CHD with implantable cardioverter-defibrillators, greater shock anxiety has been associated with poorer sexual functioning. 440 Therefore, CHD has the potential to affect patients' education, employment, relationships, and sexuality and thus overall psychosocial well-being.…”

Section: Psychosocial Prevalencementioning

confidence: 99%

Diagnosis and Management of Noncardiac Complications in Adults With Congenital Heart Disease: A Scientific Statement From the American Heart Association

Lui¹,

Saïdi²,

Bhatt³

et al. 2017

Circulation

161

134

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ABSTRACT:Life expectancy and quality of life for those born with congenital heart disease (CHD) have greatly improved over the past 3 decades. While representing a great advance for these patients, who have been able to move from childhood to successful adult lives in increasing numbers, this development has resulted in an epidemiological shift and a generation of patients who are at risk of developing chronic multisystem disease in adulthood. Noncardiac complications significantly contribute to the morbidity and mortality of adults with CHD. Reduced survival has been documented in patients with CHD with renal dysfunction, restrictive lung disease, anemia, and cirrhosis. Furthermore, as this population ages, atherosclerotic cardiovascular disease and its risk factors are becoming increasingly prevalent. Disorders of psychosocial and cognitive development are key factors affecting the quality of life of these individuals. It is incumbent on physicians who care for patients with CHD to be mindful of the effects that disease of organs other than the heart may have on the well-being of adults with CHD. Further research is needed to understand how these noncardiac complications may affect the long-term outcome in these patients and what modifiable factors can be targeted for preventive intervention.

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“…Given that a number of factors affect the cosmetic appearance of surgical wounds, such as the use of electrocautery, infection, approach, and suture material [13][14][15], we used a consistent surgical incisional approach and suture material, and electrocautery was used to perform the median sternotomy in all patients. Our results demonstrated that the Zip surgical skin closure device has cosmetic benefits, regardless of whether it was a first operation or a reoperation.…”

Section: Commentmentioning

confidence: 99%

Randomized Study of a New Noninvasive Skin Closure Device for Use After Congenital Heart Operations

Tanaka

Miyamoto

Naito

et al. 2016

The Annals of Thoracic Surgery

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Patient Attitudes to Sternotomy and Thoracotomy Scars

Cited by 23 publications

References 7 publications

Sex and Age Differences in Body-Image, Self-Esteem, and Body Mass Index in Adolescents and Adults After Single-Ventricle Palliation

Sex and Age Differences in Body-Image, Self-Esteem, and Body Mass Index in Adolescents and Adults After Single-Ventricle Palliation

Diagnosis and Management of Noncardiac Complications in Adults With Congenital Heart Disease: A Scientific Statement From the American Heart Association

Randomized Study of a New Noninvasive Skin Closure Device for Use After Congenital Heart Operations

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