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Pectus excavatum - discharge

You or your child had surgery to correct pectus excavatum. This is an abnormal formation of the rib cage that gives the chest a caved-in or sunken appearance.

Follow your doctor's instructions on self-care at home.

When You or Your Child Was in the Hospital

The surgery was done either as an open or closed procedure. With open surgery a single cut (incision) was made across the front part of the chest. With a closed procedure, two small incisions were made, one on each side of the chest. Surgical tools were inserted through the incisions to perform the surgery.

During surgery, either a metal bar or struts were placed in the chest cavity to hold the breastbone in the correct position. The metal bar will stay in place for about 1 to 3 years. The struts will be removed in 6 to 12 months.

Home Care

You or your child should walk often during the day to build up strength. You may need to help your child get in and out of bed during the first 1 to 2 weeks after surgery.

During the first month at home, be sure you or your child:

  • Always bend over at the hips.
  • Sit up straight to help keep the bar in place. DO NOT slouch.
  • DO NOT roll onto either side.

It may be more comfortable for you or your child to sleep partly sitting up in a recliner for the first 2 to 4 weeks after surgery.

You or your child should not use a backpack. Ask your surgeon how much weight is safe for you or your child to lift or carry. The surgeon may tell you that it should not be heavier than 5 or 10 pounds (2 to 4.5 kilograms).

You or your child should avoid vigorous activity and contact sports for 3 months. After that, activity is good because it improves growth of the chest and strengthens the chest muscles.

Ask the surgeon when you or your child can return to work or school.

Most dressings (bandages) will be removed by the time you or your child leaves the hospital. There may still be strips of tape on the incisions. Leave these in place. They will fall off on their own. There may be a small amount of drainage on the strips. This is normal.

Keep all follow-up appointments with the surgeon. This will likely be 2 weeks after surgery. Other doctor visits will be needed while the metal bar or strut is still in place. Another surgery will be done to remove the bar or struts. This is usually done on an outpatient basis.

You or your child should wear a medical alert bracelet or necklace while the metal bar or strut is in place. The surgeon can give you more information about this.

When to Call the Doctor

Call the surgeon if you or your child has any of the following:

  • Fever of 101°F (38.3°C), or higher
  • Increased swelling, pain, drainage, or bleeding from the wounds
  • Severe chest pain
  • Shortness of breath
  • Nausea or vomiting
  • Change in the way the chest looks since the surgery

References

Nuss D, Kelly RE. Congenital chest wall deformities. In: Holcomb GW, Murphy JP, Ostlie DJ, eds. Ashcraft's Pediatric Surgery. 6th ed. Philadelphia, PA: Elsevier Saunders; 2014:chap 20.

Putnam JB. Lung, chest wall, pleura, and mediastinum. In: Townsend CM JR, Beauchamp RD, Evers BM, Mattox KL, eds. Sabiston Textbook of Surgery: The Biological Basis of Modern Surgical Practice. 20th ed. Philadelphia, PA: Elsevier; 2017:chap 57.

Review Date 1/31/2017

Updated by: Mary C. Mancini, MD, PhD, Department of Surgery, Louisiana State University Health Sciences Center-Shreveport, Shreveport, Louisiana. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.

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