• SSB

The Bra

Working in surveillance, it is hard not to develop a strong view on patient underwear.

Pants? I am pro-pants. As hospital gowns are increasingly styled to cover the derriere, I still think pants (including disposable ones) are practical step to reducing the risk of Gram-negative bacteria in surgical wounds.

And a bra? Yes, for ladies, a bra postop, please.

But the bra has to be the right type and fit, or it becomes a liability to wound healing and skin integrity. Don’t believe me?

Compression and fluid weight gain are a bad mix. Find a lady who is seven kilos up and there will be red marks under the bra at the sides (under the arm pits). >10 kilos weight gain and under the band level with the arm pits there could be skin break. If you do find the red marks or skin break caused by the compression bra, it won’t be recorded on the SSKIN bundle (I guess perhaps because ‘back fat’ doesn’t count as a bony area or protrusion on the body).

What about tape (yes, tape)? Nadia Sawalha’s hack on Kim Kardasian-West’s boob tape isn’t a patch on how some theatres tape breasts post cardiac surgery. KK-W has already widely reported: tape ‘rips and burns’ the skin when is removed. Don’t apply tape.

The solution? We ask our ladies to bring in ‘front-fastening (to leave open at the bottom when sitting), soft (for sleeping in), supportive (needs to keep breasts in place), non-underwired and not compression style (has to stretch for fluid weight gain and be comfortable for cough)’? Ask ten female patients if they already had such a (non-flattering) bra in their possession or if they had to buy new. My guess? Most of them will tell you they had to buy new. I bet at least one will mention that it would be easier to find a unicorn than such a bra in large sizes and no fewer than four will comment on the cost.

Unwittingly, are we are contributing to a form of gender inequality in healthcare?

Female patients incur stress and costs which our male patients don’t experience. Is there an alternative? Yes. Here is a rough and ready syllogistic-like argument (to make up for the early tabloid reference) for our female cardiac patients

Major premise: Women need to buy cardiac bras which can be stressful and expensive

Minor premise: Hospital-provided cardiac bras reduce the need for women to buy them

Conclusion: Therefore, hospital-provided cardiac bras reduce the stress and costs for women

My views are thus: hospitals should be providing ladies with two surgical bras. One from theatre and the other for swapping out/washing. Whether we use KK-W words or Aristotelian logic to make the case for hospital-provided cardiac surgical bras, we need to make sure our female patients have proper support wear but also that they don’t have a different experience and cost in healthcare just because of their gender.