An example of a typical postoperative pillow.
Many hospitals supply heart patients with pillows, often called heart- chest- or cough- pillows. The purpose is to help patients to protect their sternum when they need to cough or sneeze. The question is: Could such pillows do more harm than good?
Many charity organisations supply the pillows free of charge, all with great intentions. Often the pillows are shaped as a heart, which gives a sense of comfort. They also give the impression that the hospital and its staff care about each patient and his/her recovery. Some pillows may have prints of the anatomical heart and/or the logo of the hospital.
Heart pillows can get in touch with many sources of infection.
The patient is instructed to hug the pillow, when they need to cough or sneeze. There is one problem with this: The pillow is not attached to the patient, and patients cannot carry it around at all times, like when they need to visit the bathroom. They have to reach out for it, when a cough or sneeze comes up. Will they manage to get the pillow in time? Or has the cough or sneeze already taken place when the pillow got picked up from ...the bed, a chair, a table, or the floor!
Heart pillows can get in touch with many sources of infection. This may present a risk for the sternal wound when the pillows are hugged and pressed against it. Patients continue to use the heart pillow after discharge for a long time, and may bring it around with them in and out of their home. This furthermore exposes the pillow to sources for infection.
Heart shaped pillow.
Coughing or sneezing causes a sudden rise in internal thoracic pressure. Pressing a pillow against the sternum gives counter-pressure during coughing or sneezing. However, when the patient is not coughing or sneezing, such inward pressure on the fractured sternum bone may disturb a precise alignment of the sternal bone halves and hinder a healthy healing. The problem is that many patients may use pillows for comfort during pain and press it towards the sternum, also when they don't need to cough or sneeze.
Dr. Arthur Tucker, St. Barts and the London Hospitals, is the author of a study reported in the UK news paper The Telegraph (See the article here). “Dr. Tucker found 30 different types of infection in a sample of pillows taken from hospital wards, posing a significant risk of infection!” The study was cited by The London Times and reported by Fox News: “Pillows in hospitals have been overlooked as breeding grounds for infectious germs — including superbugs”.
In another study from the University of Manchester “Pillows: A Hot Bed Of Fungal Spores”, reported in Science Daily (See the article here), the authors described how they “discovered millions of fungal spores right under our noses -- in our pillows”.
Medical literature reports that 50% to 80% of sternal wound infections are diagnosed after discharge (1, 2). The cost of sternal wound infections are reported to be between $40,000 to $80,000 (3, 4). Research is needed to verify whether the heart pillows could be a potential culprit for sternal complications.
Heart pillows could do more harm than good for the patients’ health and the health care providers’ bottom line. Hospitals should consider to use specialty products dedicated to sternotomy patients such as QualiBreath sternum and thorax support.
What is your opinion about this? Leave a comment below.
References:
1. Jonkers D, Elenbaas T, Terporten P, Nieman F, Stobberingh E. Prevalence of 90-days postoperative wound infections after cardiac surgery. European Journal of Cardio-thoracic Surgery 23 (2003) 97–102
2. Ridderstolpe L, Gill H, Granfeldt H, Ahlfeldt H, Rutberg H. Superficial and deep sternal wound complications: incidence, risk factors and mortality. Eur J Cardiothorac Surg. 2001 Dec;20(6):1168-75.
3. Graf K, Ott E, Vonberg RP, Kuehn C, Haverich A, Chaberny IF. Economic aspects of deep sternal wound infections. European Journal of Cardio-thoracic Surgery 37 (2010) 893—896
4. Speir AM, Kasirajan V, Barnett SD, Fonner E. Additive Costs of Postoperative Complications for Isolated Coronary Artery Bypass Grafting Patients in Virginia. Ann Thorac Surg 2009;88:40–6
3 comments
Mar 08, 2019 • Posted by Linda Litchfield
I have read your article about the cloth heart pillows and infections. I can understand the concern. Being an open heart surgery patient in April of 2018, Since the hospital where I was, had stopped giving out the heart pillows and I had seen a video with the patients with the heart pillow and just how useful it was- when I came out of surgery, first, thing I asked was where was my heart pillow? I was told they no longer gave them out, but a family member could buy one for the heart patient in the gift shop. Thought that was odd, but my wonderful daughter bought one for me and it was the best support I could even think of in my situation. I used it way after I went home, for other support issues for my heart. Okay cloth isn’t good I get that, but what about a material like vinyl? Couldn’t one made out of that material possibly be much safer? Or are there drawbacks to that also? Just a thought. Would love a professional’s factual opinion on this. Thank You Linda
Jul 20, 2016 • Posted by Joachim from Qualiteam
Thank you for sharing your story with us. We absolutely agree that it is worth making someone’s healing easier. This is what we focus our products on.
Your idea about making and donating pillows for this purpose to the surgeon’s office is very noble. However, as you point out too, pillows can be a dangerous risk of infection.
The other issue is that pillows are limited in their function since they do not provide any form of chest support and can only help relieve some pain if pressed against the patients chest at the right moment in time for a cough.
Studies have shown that open heart surgery patients benefit the most from a constant support to the sternum which can be easily achieved with specifically designed chest surrounding supports.
We believe that it ought to be a standard of practice for hospitals to provide chest support devices to all open heart surgery patients to make their healing easier, more comfortable and to diminish the risk of complications which would lower cost of care. Hospitals would thereby extend the postoperative care beyond the hospital and both the patient and family members would be better prepared for the return home.
Thank you again for your comment and if you have time, please have a look at the rest of our blog posts about postoperative care for open heart surgery patients and what devices are available to help them.
Best regards
Joachim
Jul 16, 2016 • Posted by Diane
My husband had open heart surgery this past June 2016 and we had a small pillow at home that is 11 inch by 11 inch and the filling is about 3 and a half inches thick. We used this for his chest whenever he had to cough and sneeze and get up from a sitting position. It protected his sternum. In the hospital they made a pillow from a blanket folded up and taped it up with masking tape. So when I got home I searched through the house to see if I could find something small enough and lightweight to serve the same purpose. It turns out that we had a decorative pillow in the guest room bedding so I used it and it was perfect for him.
I am contemplating on making pillows and donating them to my husband’s surgeon’s office and cardiologist’s office for other people to benefit from this. He only used it for about a week and a half, but it was during the time when he was very weak and in pain. Even though it might be for such a short time, it is worth making someone’s healing easier.
There are so many germs in hospitals. I think the pillows should be used only at home. The hospital pillows can stay at the hospital with all their germs. At home the pillow is clean and germ free and safe to use at such a vulnerable time.
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