Friday, April 4, 2014

Suction device for correction of pectus excavatum

Some information to file under the "good to know" category.

The suction bell  is a device that uses negative pressure (15% below atmospheric) to pull the sternum out and into a more natural position.  The principle involves repetitive intermittent use until the deformity is corrected.

In a paper by F. Haecker, the author describes a wide range of applications times, but recommends twice daily application for 30 minutes at a minimum. After the device is positioned over the deformity, the patient uses a hand pump to apply negative pressure, which instantaneously pulls the sternum up. The duration of use is limited by pain and the development of a transient subcutaneous hematoma in most of the patients.

Long term results are not available, but over a short period of use, patients experience "dramatic" results.  In the aforementioned paper, the author reports a sternal elevation of 1.5 cm in 70% of patients within a 3 month period. Again, patient dedication and level of commitment being a major determinant of outcome.  Additionally, the author suggest that the best results tend to occur in patients with milder forms of symmetric pectus excavatum.

Needless to say, this sounds like a very promising non-operative option, though the jury is still out on what is the optimal application protocol is as well as long term results and durability of the correction




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