Effect of the compressive brace in pectus carinatum
| BACKGROUND |
Patients with pectus carinatum complain of cosmetic problems because they stand out in spite of wearing clothes. Surgical treatment of pectus carinatum is resection of the deformed cartilage but a wide operative scar, postoperative pain and complications related with the operation can occur.
Therefore we have performed compressive brace therapy as a non-operative treatment of pectus carinatum, and observed the effects and the efficiency of this treatment.
| MATERIALS AND METHODS |
From January 2001 to December 2007, 119 patients with pectus carinatum were treated with a compressive brace that they wore for 24h each day.
Their degree of satisfaction was measured after 6 months wearing. This was evaluated with a score of 1-4. A score of 1 was assigned when the status was worse, 2 when it was same, 3 when partially improved, and 4 when a remarkable improvement was observed. Satisfaction was assessed subjectively by a parent if the patient was a child, and patients older than middle school age assessed the score themselves.
| RESULTS |
The mean overall satisfaction score was 3.95+/-0.4. Recurrence of pectus carinatum after removal of the compressive brace occurred in 6 (5.0%) of the total 119 patients. Four of these six patients stopped wearing the compressive brace against our advice. These six patients were re-corrected by re-wearing the compressive brace within 3 months after they originally removed it.
Complications were discomfort at initial wearing of the brace, which occurred in all patients, skin rash due to compression for 84 patients (70.6%) and skin discoloration due to excessive compression for 18 patients (15.1%). The skin rash and discoloration disappeared within a few months after removal of the brace.
| CONCLUSION |
This study demonstrated that non-surgical treatment using a compressive brace in patients with pectus carinatum was effective, especially in children and teenagers.
Non-surgical treatment using a compressive brace in patients with pectus carinatum would be helpful for those who dislike surgery because of their fear about general anesthesia and operative complications. But, long-term follow-up is necessary to evaluate the effectiveness of this compressive brace and the recurrence of the condition after its removal.
146.full_Effect of the compressive brace in pectus carinatum, Lee SY, Lee SJ, Jeon CW, Lee CS, Lee KR. Eur J Cardiothorac Surg. 2008 Jul;34(1):146-9. doi: 10.1016/j.ejcts.2008.04.012. Epub 2008 May 13.
