Vacuum Bell wear and care instructions

Types of Klobe Vacuum Bell: the pectus clinic works with Eckart Klobe, the inventor and manufacturer of the Klobe Vacuum bell, the first device developed specifically to offer a non-surgical treatment for pectus excavatum. Photo provided by Eckart Klobe

How it works

The Vacuum Bell applies negative pressure to raise the depression of the chest wall. You may view the chest wall through the polycarbonate window. Consistent application of the vacuum bell is effective in remodelling the bones, cartilage and ligaments of the chest wall over time.

Wearing schedule
Week	1-4	5	6	7	8	9	10
Minutes /day	30	45	60	75	90	105	120

Typical results
Weeks 2-4	Funnel chest is lifted close to the viewing window
Week 8	Funnel remains in a lifted position for hours before partially falling back to its sunken position
Week 12	Funnel may remain lifted by about 1cm between sessions. Improved body posture and appearance may be observed
Week 16	Continued improvement of approximately 1mm per month

End of treatment

According to Obermeyer et al., excellent correction of a funnel depth of <0.51cm can be achieved. Patient characteristics predictive of an excellent outcome including initial age ≤11 years, initial chest wall depth ≤1.5cm, chest wall flexibility and diligent wearing over 12 consecutive months.

How to apply

The Vacuum Bell is best applied at rest: before/during sleep, after a meal, or, during recovery after activities.
To avoid dizziness, ensure that you are in a sitting or supine position at the beginning and end of a treatment session. Slowly evacuate and repressurize the Vacuum Bell.
Place the Vacuum Bell over the centre of the funnel chest with the tubing nozzle above the upper part of the sternum.
Spread the outer flanks of the elastic silicone body and push them lightly against the body. This will seal the inner flanks against the skin. Once the negative pressure is established, the Vacuum Bell will adhere to the body by itself. If chest hair interferes with the seal, remove the hair.
Squeeze the suction ball completely 1 to 2 times until you feel suction; not pain. To maintain negative pressure for the duration of the treatment unit, fold the end of the silicone tube, remove the suction bulb and insert the plug. Once the negative pressure is secure with the plug, you may stand up carefully and walk about.
Slowly depresurize the Vacuum Bell at the end of treatment by turning the rotary knob on the T-valve.

How to clean

Wipe with a soft cloth that may be moistened with soap and water, ethyl alcohol, propyl alcohol (i.e., propanol) or isopropyl alcohol (i.e., isopropanol). DO NOT USE DISINFECTANTS.

DO NOT WEAR

Travel involving flights or high altitude mountain railroads
Following scuba diving
During thoracic surgery
With subcutaneious silicone or autologous fat implants in breast or funnel chest augmentation
With Poland Syndrome unless skeletal thorax is complete

SIDE EFFECTS	SOLUTIONS
Darkening of the skin (i.e., brown)	May occur and resolve after end of treatment. If buising is dark (i.e., black), seek medical attention.
Enlarged nipples (males)	May be induced by repeated touch stimulus of the Vacuum Bell. Consult your Physician.
Irritated nipples	Offset the Vacuum bell slightly to one side to completely cover one nipple while completely exposing the other nipple.
Chest tenderness	Reduce the duration of the treatment sessions and/or reduce the pressure.
Back pain	Reduce the duration of the treatment sessions and/or reduce the pressure and/or reduce level of activity during session.
Chafed skin	Reduce the duration of the treatment sessions and/or reduce the pressure and/or reduce level of activity during session.
Watery skin vesicles	Reduce the duration of the treatment sessions and/or reduce the pressure and/or reduce level of activity during session.
Flabby skin	Reduce the duration of the treatment sessions and/or reduce the pressure.
Red coloration of the skin under the Vacuum Bell	Reduce the duration of the treatment sessions and/or reduce the pressure.
Blood droplets on the skin	Reduce the duration of the treatment sessions and/or reduce the pressure and/or reduce level of activity during session.
Petechiae (pinpoint bleeding in the skin)	Typically resolves within a few weeks following end of treatment.
Acne	May develop in the suction zone under the Vacuum Bell.
Tingling arms	Reduce the duration of the treatment sessions and/or reduce the pressure.
Febrile bronchitis	Avoid chilling, reduce the duration of the treatment sessions and/or reduce the amount of negative pressure.

References

Nonoperative management of pectus excavatum with vacuum bell therapy: A single center study, Obermeyer RJ, Cohen NS, Kelly RE Jr, Ann Kuhn M, Frantz FW, McGuire MM, Paulson JF. J Pediatr Surg. 2018 Jun;53(6):1221-1225. doi: 10.1016/j.jpedsurg.2018.02.088. Epub 2018 Mar 8.

Incorporating vacuum bell therapy into pectus excavatum treatment, Obermeyer RJ. J Vis Surg. 2016 May 18;2:99. doi: 10.21037/jovs.2016.05.01. Full text, PDF