To perform open heart surgery, a surgeon needs to cut through a person’s sternum in a procedure known as a sternotomy. It is a major operation that involves a lengthy healing process that can take months.
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A person can help prevent complications by caring for their wound and gradually reintroducing physical activity according to the doctor’s instructions when they get home.
Read on to learn more about sternum healing after open heart surgery.
Full recovery following a sternotomy is possible, but it is a long process.
After surgery, the surgeon will use strong wire to hold the cut bones together, allowing new cells to grow. Over the course of months, the bones fuse back together.
Before a person leaves hospital, a health professional will typically remove a person’s surgical dressings. At home, once the wound is clean and dry, it is safe to use the shower, or take a short bath, as long as a person takes care not to push or pull too hard getting in or out.
However, a person should avoid using fragranced soaps, creams, or powders, which may irritate the wound. They should also avoid rubbing the wound too vigorously when drying after washing. No matter how itchy the wound may feel, they should avoid scratching or picking, as this can lead to infection.
Doctors recommend that a person eases their way back into everyday activities gently. The key is to start small and take plenty of breaks. Rest when tired, and do not try to push through fatigue or pain.
The first 3 months after surgery
During the first 3 months after open heart surgery, it is safe to do easy chores around the house and yard, such as:
- washing dishes
- folding clothes
- pruning flowers
Social activities, such as going to the movies and restaurants, are also safe as long as they do not involve a lot of physical effort.
A person should aim to some walking every day. Start with a short distance and try to walk up, little by little. Walking supports blood circulation and helps to reduce the risk of pneumonia and constipation.
It is also safe to use an indoor stationary bicycle at this stage, but only at a gentle pace.
A person can probably return to work after 1–3 months. However, this will depend on the type of work they do and how physically demanding it is.
To help manage pain, a person can sleep on their back. If they need to cough or take a deep breath, it can help to hold a pillow over the wound to support the sternum.
A person should ask their doctor when it will be safe for them to drive again.
The next 3 months after surgery
A person can keep doing the activities they did during the first 3 months, but increase their exertion levels slightly. Activities that are safe to do during this second phase of recovery include:
- vacuuming
- sweeping
- laundry
- mowing the lawn
- raking leaves
- travel, for business or leisure
For the first 6 weeks after surgery, a person should avoid lifting anything that causes them to strain. This could be a heavy grocery bag, briefcase, backpack, a pet, or a child.
Activities to avoid for the first 3 months after surgery, or until a doctor says it is safe to continue, include:
- household activities that strain the chest or upper arm muscles, such as mowing the lawn, vacuuming, and mopping the floor
- sports such as tennis, golf, cycling, weight lifting, running, and vigorous aerobics
- pulling the body up using the arms, such as getting into a high truck or SUV
People heal at different rates depending on a range of different factors, including their underlying state of health and their age.
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Open heart surgery is a major operation, and complications can sometimes occur.
A 2018 study reviewed different types of medical scans from people with typical healing after open heart surgery and those with complications. The researchers identified complications relating to:
- bone healing
- bleeding
- infection
There can also be complications with the wire surgeons use to draw the sternum back together. If a wire breaks, it may cause a person to experience pain, a clicking noise when they move, or the wire to stick through their skin.
Doctors treat complications on a case-by-case basis. If the person has minimal symptoms, this may involve regular monitoring. If a person’s symptoms are more severe, the doctor may consider a further procedure.
Sometimes the person’s sternum does not heal back together properly. Risk factors for this complication include:
- obesity
- osteoporosis
- chest wall radiation therapy
- taking steroids
- paramedian closure, which is when the surgical incision is off-center
People with diabetes or obesity have a higher risk of developing a serious infection after open heart surgery. Mediastinitis, an infection that causes swelling and irritation between the lungs, can cause:
- fever
- pain
- rash
- an unstable sternum
- wound opening
Some people may also develop an abscess in their sternum. Risk factors for this complication include:
- diabetes
- smoking
- obesity
- the presence of Staphylococcus aureus bacteria
- prolonged surgery
- improper surgical technique
- inadequate wound care
- hypothermia due to the anesthetic used during surgery
While some of these risk factors are out of the hands of the person undergoing surgery, there are some things that a person can do to lower their risk of complications. These include:
- maintaining a health body weight
- eating a healthy diet
- avoiding smoking
- taking good care of their surgical wound
If a problem develops with a person’s wound following open heart surgery, it may cause one of more of the following symptoms:
- inflammation
- heat or swelling
- a change in the level of pain
- pus or discharge
- an unpleasant odor
- the wound opening up
- clicking or grinding in the breastbone
A person should check their wound every day for all of these signs of a complication. If any appear, they should contact their doctor immediately.
Sternum healing after open heart surgery can take months, or for some people, years. During this time, people need to care for the wound to lower the risk of any complications. To begin with, they will need to stick to easier chores and physical activities.
People can often begin resuming their usual activities within 6 months. Sometimes, complications occur, such as infections. Contact a doctor immediately if any new symptoms appear or existing symptoms get worse.