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Sternal Precautions, Ambulatory Care

Sternal precautions

are used to help protect your sternum (breastbone) after open chest surgery. Wires are placed during surgery to hold the sternum together as it heals. Sternal precautions help prevent the wires from cutting through the sternum. The precautions also help prevent the sternum from coming apart from an injury, and prevent pain and bleeding. You may need to use the precautions for up to 12 weeks after surgery. Your surgeon will give you specific instructions based on the type of surgery you had. It is important to follow the instructions carefully. An injury to the healing sternum can be life-threatening.

General sternal precautions:

Start slowly and do more as you get stronger. Pain medicine might make it harder for you to know when to slow down or be careful. Stop immediately if you hear a crunch or pop in your sternum.

  • Protect your sternum. Hug a pillow to your chest or cross your arms over your chest when you laugh, sneeze, or cough.
  • Be careful when you get into or out of a chair or bed. Hug a pillow or cross your arms when you stand or sit. Do not twist as you move. Use only your legs to sit and stand. You may need to use a raised toilet seat if you have trouble standing up without using your arms. Your healthcare provider may teach you to use your elbow for support as you move from lying to sitting.
  • Ask when you may take a bath or shower. You may need to use a bath chair if you have trouble getting into or out of the tub. Do not use a grab bar.
  • Do not lift or carry anything heavier than 5 pounds. For example, a gallon of milk weighs 8 pounds.
  • Keep your arms down as much as possible. Do not put your arms out to the side, behind you, or over your head. Do not let anyone pull your arms to help you move or dress. Do not reach for items.
  • Do not push or pull anything. Examples include a car door or a vacuum cleaner.
  • Do not drive while you are healing. Your surgeon will tell you when it is safe for you to start driving again.

Seek immediate care for the following symptoms:

  • A crunch or pop in your sternum
  • Bleeding that does not stop even after you apply pressure for 5 minutes
  • Signs of an infection, such as a fever, red or warm skin, or pus in the wound

Care for your surgery wound:

Always wash your hands before you care for your wound. Wash your wound as directed. Do not rub the wound as you wash or dry the area. Pat the area dry with a clean towel. Change the bandages as directed and when they get wet or dirty.

Do not smoke:

If you smoke, it is never too late to quit. Smoking can delay healing, and increase your risk for complications and cancer. Smoking can also damage your heart, lungs, and esophagus. Ask your healthcare provider for information if you need help quitting.

Follow up with your healthcare provider as directed:

Write down your questions so you remember to ask them during your visits.

Care Agreement

You have the right to help plan your care. Learn about your health condition and how it may be treated. Discuss treatment options with your caregivers to decide what care you want to receive. You always have the right to refuse treatment. The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.

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