A national clinical trial led by a University of Calgary researcher has found that wearing a specialized compression bra significantly reduces women's breast pain following heart surgery.
The study, funded by the Canadian Institutes for Health Research, is the first to provide scientific data that a supportive undergarment of this type is safe, effective and can be worn almost immediately after cardiac surgery.
Dr. Kathryn King, an Alberta Heritage Foundation for Medical Research Population Health Investigator who holds joint appointments in the U of C's Faculty of Nursing and the Faculty of Medicine, will present her findings on Sunday, Oct. 22, at the Canadian Cardiovascular Congress in Vancouver.
"Women who wore the bra after surgery had a great deal less pain and discomfort in their breasts -- such as numbness, tingling or shooting sensations -- than those in the control group," King says. She and her colleagues looked at the post-operative experiences of 481 women from 10 different cities across Canada.
Unlike conventional bras, the post-operative bra that was tested fastens in the front, doesn't have any metal clasps that can interfere with x-rays, provides extra compression, and can be adjusted to accommodate changing breast sizes, which sometimes occurs after surgery.
"On the whole, the women loved it," King says. "It's easy to put on, and it also helps protect their modesty."
Women have usually been advised to wear a comfortable undergarment after a sternotomy, which is the procedure that opens up the breastbone, but until now the assumed benefits have never been substantiated by research. Several women in the study wore it right out of the operating room whereas today, women often wait until three or four days after surgery before putting on a bra.
Women with large breasts, in particular, often encounter difficulties in their recovery, King says, so they will likely benefit the most. She says she first got the idea for the study 10 years ago when she worked in the Intensive Care Unit of Calgary's Holy Cross Hospital and watched women struggle with post-operative pain. About one-third of all cardiac surgeries are performed on women.
Christine Smith, a Calgary woman who underwent heart surgery last year and began using the bra shortly after leaving the Intensive Care Unit, believes the bra was extremely helpful in her recovery. "It was wonderful," Smith says. "It gives you that feeling of security when you've just had your sternum separated -- you worry about that, but with the bra you feel a lot safer."
King notes that one of the interesting findings from the study is that women typically didn't have a lot of pain while they were in hospital. "But when they got out of hospital their pain scores went up significantly and we attributed that to the greater amounts of activity they have when they go home."
The Women's Recovery from Sternotomy Trial or WREST, as it was called, also involved three other Calgary-based researchers and two from Edmonton, including Dr. Ross Tsuyuki, Professor of Medicine (Cardiology) and Director of the Epidemiology Coordinating and Research (EPICORE) Centre, a clinical trials and health outcomes research centre at the University of Alberta. EPICORE Centre was involved in the design and data management for the study.
"I am very pleased with the outcome of the study because not only are we able to offer something to help ease the suffering of women after sternotomy, but we were able to evaluate it with a high degree of scientific rigor," Tsuyuki says.
Adds Dr. Andrew Maitland, Chief of Cardiac Surgery for the Calgary Health Region: "This is an excellent example of patient-centred collaborative research."
A related paper on the study will be published soon in the American Heart Journal.
King says one of her research collaborators, Dr. Gillian Currie, will next consider the economic feasibility of the bras, which are not currently covered by health insurance. Researchers are also studying whether the bra promotes a reduction in scarring.
The Canadian Cardiovascular Congress, hosted by the Heart and Stroke Foundation of Canada and the Canadian Cardiovascular Society, will see King's presentation, Early Use of a Novel Undergarment Following Sternotomy: The Women's Recovery from Sternotomy Trial, on Sunday, Oct. 22.
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