Presenter Status
Established Investigator
Abstract Type
QI Project
Primary Mentor or Principal Investigator
Dr. Tolulope Oyetunji
Presentation Type
Poster
Start Date
21-5-2026 11:00 AM
End Date
21-5-2026 12:00 PM
Abstract Text
Problem Statement/Question:
Management of pectus carinatum (PC) using the Dynamic Compression System (DCS) varies in recommended wear time, follow‑up intervals, brace adjustments, and measurement of pressure of initial correction (PIC). This variability may contribute to inconsistent outcomes in correction rates, and unclear expectations for patients and families. How can DCS treatment parameters—PIC trends, wear recommendations, and visit frequency—be standardized to improve consistency, predictability, and overall patient outcomes?
Introduction:
PC is a protuberant chest wall deformity that may be asymptomatic but can significantly affect body image and psychosocial well‑being, leading many patients to seek treatment. Bracing is considered first‑line therapy for most children. At our Pectus Center, the DCS is used to gradually remodel the chest through targeted external compression. Given the variability in provider practice and patient compliance, we identified treatment gaps and a lack of standardized care.
Background/Project Intent:
Bracing is widely accepted as the preferred non‑surgical treatment for PC. Few evidence‑based guidelines exist for the optimal use of DCS bracing. The aim of this project was to analyze brace pressure trends, wear patterns, and visit intervals to develop data‑driven DCS guidelines. We sought to establish evidence‑based recommendations to enhance consistency, predictability, and outcomes in PC management at our institution.
Methods:
The DCS applies targeted pressure to the sternum, guided by PIC, recorded in pounds per inch (PSI) of pressure. Brace pressures are adjusted throughout treatment based on patient response. We conducted a QI project analyzing patient age, PIC, wear duration, and visit patterns to standardize clinical parameters.
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PDSA Cycle 1 – Standardizing PIC Measurement: Assessed variability, implemented a uniform protocol, and adopted standardized PIC measurement.
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PDSA Cycle 2 – Optimizing Wear-Time Guidance: Identified inconsistent wear recommendations, introduced initial wear schedules and standardized education based on PIC.
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PDSA Cycle 3 – Streamlining Visit Frequency: Evaluated follow-up intervals and correction trends and implemented visit intervals for active and retainer phases.
Results:
From January 2021 to January 2025, 232 patients with ≥5 consecutive visits after DCS initiation were analyzed. The mean age was 14.9 years; 91% were male. Patients averaged 8.15 visits during active correction. PIC demonstrated a consistent linear decrease of 0.73 PSI over the first six visits, indicating effective chest wall remodeling. Reported brace wear hours decreased linearly by 2.07 across six consecutive visits, reflecting gradual reduction in required wear time as correction progressed.
Conclusion:
Key predictive factors, such as brace pressure and PIC trends, influence both comfort and correction efficacy during DCS treatment. The observed decrease in PIC provides evidence of progressive chest wall remodeling, while reduced wear time and visit frequency offer practical benchmarks for clinicians and families. These findings support the development of standardized treatment protocols and enhance patient-centered care. Ongoing data collection will further refine practice and improve long-term outcomes for patients with PC.
Quality Improvement in the Management and Treatment of Pectus Carinatum Using the Dynamic Compression System
Problem Statement/Question:
Management of pectus carinatum (PC) using the Dynamic Compression System (DCS) varies in recommended wear time, follow‑up intervals, brace adjustments, and measurement of pressure of initial correction (PIC). This variability may contribute to inconsistent outcomes in correction rates, and unclear expectations for patients and families. How can DCS treatment parameters—PIC trends, wear recommendations, and visit frequency—be standardized to improve consistency, predictability, and overall patient outcomes?
Introduction:
PC is a protuberant chest wall deformity that may be asymptomatic but can significantly affect body image and psychosocial well‑being, leading many patients to seek treatment. Bracing is considered first‑line therapy for most children. At our Pectus Center, the DCS is used to gradually remodel the chest through targeted external compression. Given the variability in provider practice and patient compliance, we identified treatment gaps and a lack of standardized care.
Background/Project Intent:
Bracing is widely accepted as the preferred non‑surgical treatment for PC. Few evidence‑based guidelines exist for the optimal use of DCS bracing. The aim of this project was to analyze brace pressure trends, wear patterns, and visit intervals to develop data‑driven DCS guidelines. We sought to establish evidence‑based recommendations to enhance consistency, predictability, and outcomes in PC management at our institution.
Methods:
The DCS applies targeted pressure to the sternum, guided by PIC, recorded in pounds per inch (PSI) of pressure. Brace pressures are adjusted throughout treatment based on patient response. We conducted a QI project analyzing patient age, PIC, wear duration, and visit patterns to standardize clinical parameters.
-
PDSA Cycle 1 – Standardizing PIC Measurement: Assessed variability, implemented a uniform protocol, and adopted standardized PIC measurement.
-
PDSA Cycle 2 – Optimizing Wear-Time Guidance: Identified inconsistent wear recommendations, introduced initial wear schedules and standardized education based on PIC.
-
PDSA Cycle 3 – Streamlining Visit Frequency: Evaluated follow-up intervals and correction trends and implemented visit intervals for active and retainer phases.
Results:
From January 2021 to January 2025, 232 patients with ≥5 consecutive visits after DCS initiation were analyzed. The mean age was 14.9 years; 91% were male. Patients averaged 8.15 visits during active correction. PIC demonstrated a consistent linear decrease of 0.73 PSI over the first six visits, indicating effective chest wall remodeling. Reported brace wear hours decreased linearly by 2.07 across six consecutive visits, reflecting gradual reduction in required wear time as correction progressed.
Conclusion:
Key predictive factors, such as brace pressure and PIC trends, influence both comfort and correction efficacy during DCS treatment. The observed decrease in PIC provides evidence of progressive chest wall remodeling, while reduced wear time and visit frequency offer practical benchmarks for clinicians and families. These findings support the development of standardized treatment protocols and enhance patient-centered care. Ongoing data collection will further refine practice and improve long-term outcomes for patients with PC.
Comments
Poster Board Number: 29