Pectus carinatum patients report high satisfaction with bracing

In a study of patient experiences and satisfaction with dynamic compression bracing to treat pectus carinatum, researchers found that the bracing was effective in achieving correction in compliant patients and that patients reported high satisfaction with the bracing.

The O&P EDGE June 28, 2019

The research team from Children’s Mercy Hospital, Kansas City, Missouri, conducted a prospective institutional data review of patients who underwent dynamic compression bracing to treat pectus carinatum from July 2011 to June 2018. Data were analyzed for those who entered the retainer mode after correction, defined by a correction pressure of less than 1 psi, and a telephone survey was conducted regarding the patients’ bracing experience and satisfaction with the outcome on a scale of one to ten.

Of 460 patients, 144 reached the retainer mode. Median time to retainer mode was 5.5 months. There was no statistically significant relationship between initial correction pressure or carinatum height and time to retainer mode. Fifty-seven percent were compliant with brace use, and median time to retainer mode in this subset was significantly shorter than noncompliant patients (3.5 months versus 10 months). Fifty-three percent of the patients responded to the survey 13 months after the last clinic visit.

The main barrier to compliance with wearing the brace was discomfort (37 percent), while the main motivation for compliance was appearance (58 percent). All respondents endorsed bracing as worthwhile, with 94 percent reporting a satisfaction rating of eight or greater for the correction outcome.

The study was published in the Journal of Laparoendoscopic & Advanced Surgical Techniques.

Source The O&P EDGE

Outcomes Following Dynamic Compression Bracing for Pectus Carinatum, Dekonenko C, Dorman RM, Pierce A, Orrick BA, Juang D, Aguayo P, Fraser JD, Oyetunji TA, Snyder CL, St Peter SD, Holcomb GW 3rd. J Laparoendosc Adv Surg Tech A. 2019 Jun 26. doi: 10.1089/lap.2019.0171. [Epub ahead of print]

  Further reading
Outcomes Following Dynamic Compression Bracing for Pectus Carinatum, Dekonenko C, Dorman RM, Pierce A, Orrick BA, Juang D, Aguayo P, Fraser JD, Oyetunji TA, Snyder CL, St Peter SD, Holcomb GW 3rd. J Laparoendosc Adv Surg Tech A. 2019 Jun 26. doi: 10.1089/lap.2019.0171. [Epub ahead of print]

Effectiveness of Compressive External Bracing in Patients with Flexible Pectus Carinatum Deformity: A Review, Hunt I, Patel AJ. Thorac Cardiovasc Surg. 2019 Apr 25. doi: 10.1055/s-0039-1687824. [Epub ahead of print]

Long-Term Results of Compressive Brace Therapy for Pectus Carinatum, Moon DH, Kang MK, Lee HS, Lee S. Thorac Cardiovasc Surg. 2019 Jan;67(1):67-72. doi: 10.1055/s-0038-1669927. Epub 2018 Sep 14.

A Simplified Method for Three-Dimensional Optical Imaging and Measurement of Patients with Chest Wall Deformities, Szafer D, Taylor JS, Pei A, de Ruijter V, Hosseini H, Chao S, Wall J. J Laparoendosc Adv Surg Tech A. 2019 Feb;29(2):267-271. doi: 10.1089/lap.2018.0191. Epub 2018 Sep 12.

Measured dynamic compression for pectus carinatum: A systematic review, de Beer SA, Blom YE, Lopez M, de Jong JR. Semin Pediatr Surg. 2018 Jun;27(3):175-182. doi: 10.1053/j.sempedsurg.2018.06.001. Epub 2018 Jun 15. Review.

Bracing of pectus carinatum: A quantitative analysis, Bugajski T, Murari K, Lopushinsky S, Schneider M, Ronsky J. J Pediatr Surg. 2018 May;53(5):1014-1019. doi: 10.1016/j.jpedsurg.2018.02.034. Epub 2018 Feb 13.

Success and duration of dynamic bracing for pectus carinatum: A four-year prospective study, Emil S, Sévigny M, Montpetit K, Baird R, Laberge JM, Goyette J, Finlay I, Courchesne G. J Pediatr Surg. 2017 Jan;52(1):124-129. doi: 10.1016/j.jpedsurg.2016.10.032. Epub 2016 Oct 27.

Pectus Carinatum: Factors That Contribute to Success and Failure of Nonoperative Treatment, Thaker S, Anderson M, Fezio J, Rader C, Misra MV. Conn Med. 2017 Apr;81(4):203-208.

Factors affecting patient compliance with compressive brace therapy for pectus carinatum, Kang DY, Jung J, Chung S, Cho J, Lee S. Interact Cardiovasc Thorac Surg. 2014 Dec;19(6):900-3. doi: 10.1093/icvts/ivu280. Epub 2014 Aug 27.

Bracing in pediatric patients with pectus carinatum is effective and improves quality of life, Colozza S, Bütter A. J Pediatr Surg. 2013 May;48(5):1055-9. doi: 10.1016/j.jpedsurg.2013.02.028. PDF

Bracing is an effective therapy for pectus carinatum: interim results, Lee RT, Moorman S, Schneider M, Sigalet DL. J Pediatr Surg. 2013 Jan;48(1):184-90. doi: 10.1016/j.jpedsurg.2012.10.037. PDF

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