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Clinical Hub,Patient Education,Health and Nutrition Facts For You,Pediatrics, Parenting

Pectus Excavatum (6046)

Pectus Excavatum (6046) - Clinical Hub, Patient Education, Health and Nutrition Facts For You, Pediatrics, Parenting

6046




Pectus excavatum is the most common
problem of the chest in children. It is also
known as “sunken chest” or “funnel chest”
because it can look like a sunken area of the
sternum (breastbone). Fixing your child’s
breastbone is done using the Nuss
procedure. This involves placing a metal
“pectus bar” to help reshape the chest wall.
Small incisions are made on each side of the
chest and just under the breastbone.

Surgery takes about 1 – 1 ½ hours and your
child will stay in the hospital for 4-5 days.
The bar stays in place for 2-3 years. The
breastbone is then be strong enough to keep
its new shape. Children usually need to be
home for 1-2 weeks after surgery. Your
child may go back to school when they have
more energy and their pain is controlled.

Activity
Activity is very limited for the first 2 months
after surgery. This is so that the bar is not
dislodged. During this time your child can
not:
ξ Lift anything that weighs more than
25 pounds,
ξ Play contact sports (for at least 2-3
months). After that, any activity
restrictions are directed by your
surgeon.
ξ Participate in gym or recess
ξ Carry heavy books because of pain.
You may want to arrange for books
to be kept in the classroom or use a
rolling backpack.
Good posture is very important and walking
up or down stairs is ok anytime. Once
healed, chest strengthening exercises
should be restarted.


Incision Care
All surgical incisions are closed with
dissolving stitches that are under the skin.
The incisions are pink at first and will
slowly fade over the next year. The incisions
are covered with white steri-strips and
special glue. Do not pull these off. The strips
will curl up and fall off on their own as the
incisions heal. If steri-strips are still on after
one week, you may gently remove them. A
few other important tips:
ξ Your child may shower 3 days after
surgery and bathe 1 week after.
ξ Do not put ointment, powders, or
cream on the incision sites.
ξ Once healed, use SPF 30 sunscreen
on the scars when out in the sun for
at least 1 year.

Pain and Constipation
Pain can be expected after surgery. Your
child may need prescription pain medicine
for up to 3 weeks after surgery. After this
time, you should be able to control your
child’s pain with Ibuprofen (Motrin/Advil)
or acetaminophen (Tylenol). It is important
that your child take pain medicine as
prescribed to control the pain.

One of the main side effects of prescription
pain medicine is constipation. Though they
may not like to talk about it, it is important
that children know about this common and
troublesome side effect. Children may report
nausea and trouble eating and drinking 4-5
days after surgery. If your child is not able
to eat, it will be hard to tolerate the pain
medicine.





Ways to Help Your Child Have a Bowel
Movement
ξ Enema. If your child is in the
hospital, the nursing staff will help to
give the enema. If you are at home,
you can buy a Fleets enema over-the-
counter.
ξ Drink plenty of fluids.
ξ Eat fruits and vegetables.
ξ Add fiber to the diet.
ξ Take recommended doses of stool
softeners.

Diet
Your child may eat what he/she chooses.
Eating healthy foods promotes good healing.

MedicAlert
You may choose to have your child wear a
MedicAlert bracelet or necklace. It should
read: “surgical steel bar in chest, CPR
more force, cardiac defibrillation ant/post
pad placement” You can order one from
the address listed below:

MedicAlert Foundation International
2323 Colorado Ave. / Turlock, CA 95382
800-432-5378 / www.medicalert.org

When to Call
Please call if you notice any of the
symptoms below:

ξ The incision is red, swollen, very
painful, or has drainage.
ξ You think that the bar has become
dislodged (chest changes shape, your
child has been hit forcefully in the
chest).
ξ Your child is still having trouble
with bowel movements after an
enema.
ξ Chest pain, especially with deep
breaths or any trouble breathing.

More Post-surgery Information
ξ No chest or thorax MRIs are
allowed. If an MRI of the lower body
is needed, talk with the radiologist
first to make sure it is safe to do an
MRI with the steel bar in place.
ξ Antibiotic prophylaxis is not needed
for dental procedures unless your
child has a history of mitral valve
prolapse.
ξ We will provide a medical travel
letter which your child may need in
passing through security devices at
the airport, etc.


Phone Numbers:
If you have questions or concerns, please
call:

Monday – Friday 8:00am – 4:30pm:
(608) 263-6420, option 1
After hours and weekends: (608)262-2122
- Ask for the pediatric surgery resident on
call. Leave your name, child’s full name,
and phone number with area code. The
doctor will call you back





Your health care team may have given you this information as part of your care. If so, please use it and call if you
have any questions. If this information was not given to you as part of your care, please check with your doctor. This
is not medical advice. This is not to be used for diagnosis or treatment of any medical condition. Because each
person’s health needs are different, you should talk with your doctor or others on your health care team when using
this information. If you have an emergency, please call 911. Copyright © 10/2016 University of Wisconsin Hospitals
and Clinics Authority. All rights reserved. Produced by the Department of Nursing HF#6046.