284 lines
No EOL
28 KiB
HTML
284 lines
No EOL
28 KiB
HTML
<!DOCTYPE html>
|
||
<html lang="en" id="article" class="nojs us" data-root="//medlineplus.gov" itemid="https://medlineplus.gov/ency/article/007626.htm" itemtype="http://schema.org/MedicalWebPage" itemscope="">
|
||
<head>
|
||
<meta http-equiv="X-UA-Compatible" content="IE=edge,chrome=1"/>
|
||
<meta http-equiv="window-target" content="_top"/>
|
||
<meta http-equiv="Content-Type" content="text/html; charset=UTF-8"/>
|
||
<meta charset="utf-8"/>
|
||
<meta property="fb:app_id" content="1042245625821448"/>
|
||
<meta name="expires" content="Wed, 05 02 2025"/>
|
||
<meta name="ac-dictionary" content="medlineplus-ac-dictionary"/>
|
||
<link rel="shortcut icon" href="https://medlineplus.gov/images/favicon.ico" type="image/x-icon"/>
|
||
<link rel="apple-touch-icon" href="//medlineplus.gov/images/touch-icon.png"/>
|
||
<meta name="viewport" content="width=device-width, initial-scale=1"/>
|
||
<link rel="stylesheet" href="https://medlineplus.gov/css/common_new.css?04272023"/>
|
||
<!--[if IE 8]> <link rel="stylesheet" href="https://medlineplus.gov/css/ie8/common.css"><![endif]-->
|
||
<link rel="stylesheet" href="https://medlineplus.gov/uswds/css/uswds_styles.css"/>
|
||
<link rel="stylesheet" href="https://medlineplus.gov/css/ency/ency2.css?07162024"/>
|
||
<script type="text/javascript">document.querySelector("html").className = document.querySelector("html").className.replace(/nojs[\s]*/g, '');</script>
|
||
<script src="https://medlineplus.gov/uswds/js/uswds-init.min.js" type="text/javascript">
|
||
</script>
|
||
<script>(function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='//www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-MMVM77');</script>
|
||
<link rel="canonical" href="https://medlineplus.gov/ency/article/007626.htm" itemprop="url"/>
|
||
<link rel="alternative" hreflang="es" href="https://medlineplus.gov/spanish/ency/article/007626.htm"/>
|
||
<link rel="alternative" hreflang="en" href="https://medlineplus.gov/ency/article/007626.htm"/><meta property="og:title" content="Sternal exploration or closure: MedlinePlus Medical Encyclopedia"/><meta property="og:url" content="https://medlineplus.gov/ency/article/007626.htm"/><meta property="twitter:title" content="Sternal exploration or closure: MedlinePlus Medical Encyclopedia"/><meta name="twitter:card" content="summary_large_image"/><meta name="description" content="When you have open heart surgery, the surgeon may make a cut (incision) that runs down the middle of your chest bone (sternum). The incision usually heals on its own after it is repaired. But sometimes,"/><meta itemprop="description" name="description" content="When you have open heart surgery, the surgeon may make a cut (incision) that runs down the middle of your chest bone (sternum). The incision usually heals on its own after it is repaired. But sometimes,"/><meta property="og:description" content="When you have open heart surgery, the surgeon may make a cut (incision) that runs down the middle of your chest bone (sternum). The incision usually heals on its own after it is repaired. But sometimes,"/><meta property="twitter:description" content="When you have open heart surgery, the surgeon may make a cut (incision) that runs down the middle of your chest bone (sternum). The incision usually heals on its own after it is repaired. But sometimes,"/><meta property="og:image" content="https://medlineplus.gov/images/share_ency_1.jpg"/><meta property="og:image" content="https://medlineplus.gov/images/share_ency_2.jpg"/><meta property="og:image" content="https://medlineplus.gov/images/share_ency_3.jpg"/><meta property="twitter:image" content="https://medlineplus.gov/images/share_ency_1.jpg"/>
|
||
<title>Sternal exploration or closure: MedlinePlus Medical Encyclopedia</title>
|
||
</head>
|
||
<body><link href="http://schema.org/Patient" itemprop="audience"/>
|
||
<!-- Google Tag Manager -->
|
||
<noscript><iframe title="googletagmanager" src="//www.googletagmanager.com/ns.html?id=GTM-MMVM77" height="0" width="0" style="display:none;visibility:hidden">
|
||
</iframe>
|
||
</noscript>
|
||
<!-- End Google Tag Manager -->
|
||
<a name="top" id="top">
|
||
</a>
|
||
<a class="hide-offscreen" href="#start">Skip navigation</a>
|
||
<section class="usa-banner" aria-label="Official website of the United States government">
|
||
<div class="usa-accordion">
|
||
<header class="usa-banner__header">
|
||
<div class="usa-banner__inner">
|
||
<div class="grid-col-auto">
|
||
<img aria-hidden="true" class="usa-banner__header-flag" src="https://medlineplus.gov/uswds/img/us_flag_small.png" alt=""/>
|
||
</div>
|
||
<div class="grid-col-fill tablet:grid-col-auto" aria-hidden="true">
|
||
<p class="usa-banner__header-text">
|
||
An official website of the United States government
|
||
</p>
|
||
<p class="usa-banner__header-action">Here’s how you know</p>
|
||
</div>
|
||
<button type="button" class="usa-accordion__button usa-banner__button" aria-expanded="false" aria-controls="gov-banner-default-default">
|
||
<span class="usa-banner__button-text">Here’s how you know</span>
|
||
</button>
|
||
</div>
|
||
</header>
|
||
<div class="usa-banner__content usa-accordion__content" id="gov-banner-default-default">
|
||
<div class="grid-row grid-gap-lg">
|
||
<div class="usa-banner__guidance tablet:grid-col-6">
|
||
<img class="usa-banner__icon usa-media-block__img" src="https://medlineplus.gov/uswds/img/icon-dot-gov.svg" role="img" alt="" aria-hidden="true"/>
|
||
<div class="usa-media-block__body">
|
||
<p>
|
||
<strong>Official websites use .gov</strong><br/>A
|
||
<strong>.gov</strong> website belongs to an official government
|
||
organization in the United States.
|
||
</p>
|
||
</div>
|
||
</div>
|
||
<div class="usa-banner__guidance tablet:grid-col-6">
|
||
<img class="usa-banner__icon usa-media-block__img" src="https://medlineplus.gov/uswds/img/icon-https.svg" role="img" alt="" aria-hidden="true"/>
|
||
<div class="usa-media-block__body">
|
||
<p>
|
||
<strong>Secure .gov websites use HTTPS</strong><br/>A
|
||
<strong>lock</strong> (
|
||
<span class="icon-lock"><svg xmlns="http://www.w3.org/2000/svg" width="52" height="64" viewBox="0 0 52 64" class="usa-banner__lock-image" role="img" aria-labelledby="banner-lock-description-default" focusable="false">
|
||
<title id="banner-lock-title-default">Lock</title>
|
||
<desc id="banner-lock-description-default">Locked padlock icon</desc>
|
||
<path fill="#000000" fill-rule="evenodd" d="M26 0c10.493 0 19 8.507 19 19v9h3a4 4 0 0 1 4 4v28a4 4 0 0 1-4 4H4a4 4 0 0 1-4-4V32a4 4 0 0 1 4-4h3v-9C7 8.507 15.507 0 26 0zm0 8c-5.979 0-10.843 4.77-10.996 10.712L15 19v9h22v-9c0-6.075-4.925-11-11-11z">
|
||
</path>
|
||
</svg> </span>) or <strong>https://</strong> means you’ve safely connected to
|
||
the .gov website. Share sensitive information only on official,
|
||
secure websites.
|
||
</p>
|
||
</div>
|
||
</div>
|
||
</div>
|
||
</div>
|
||
</div>
|
||
</section>
|
||
<div id="mplus-wrap">
|
||
<header>
|
||
<div id="mplus-header">
|
||
<!-- Orgs
|
||
================================================== -->
|
||
<div id="mplus-orgs">
|
||
<a title="National Institutes of Health" target="_blank" class="nih-org" href="//www.nih.gov/">
|
||
<img alt="National Institutes of Health" src="https://medlineplus.gov/images/nihlogo.png" class="nihlogo"/>
|
||
</a><a target="_blank" href="https://www.nlm.nih.gov/"> National Library of Medicine </a>
|
||
</div>
|
||
<!-- Logo
|
||
================================================== -->
|
||
<div id="mplus-logo" class="years-25">
|
||
<a href="https://medlineplus.gov">
|
||
<img src="https://medlineplus.gov/images/m_logo_25.png" title="MedlinePlus Trusted Health Information for You" alt="MedlinePlus Trusted Health Information for You"/>
|
||
</a>
|
||
</div>
|
||
<!-- Nav Menu
|
||
================================================== -->
|
||
<div id="mplus-nav">
|
||
<div class="sm-live-area hide-offscreen" aria-live="polite">The navigation menu has been collapsed.</div>
|
||
<!-- Menu Button-->
|
||
<button type="submit" aria-controls="mplus-menu-list" role="button" title="Menu" class="navmenu-btn" id="sm-menu-btn" aria-pressed="false" tabindex="0">Menu<span class="icon icon-nav-menu">
|
||
</span></button><ul class="nav-list" id="mplus-menu-list">
|
||
<li><a href="https://medlineplus.gov/healthtopics.html">Health Topics</a></li>
|
||
<li><a href="https://medlineplus.gov/druginformation.html">Drugs & Supplements</a></li>
|
||
<li><a href="https://medlineplus.gov/genetics/">Genetics</a></li>
|
||
<li><a href="https://medlineplus.gov/lab-tests/">Medical Tests</a></li>
|
||
<li><a href="https://medlineplus.gov/encyclopedia.html">Medical Encyclopedia</a></li>
|
||
<li><a href="https://medlineplus.gov/about/">About MedlinePlus</a></li>
|
||
</ul><button type="submit" aria-controls="mplus-search" role="button" title="Search" class="navmenu-btn" id="sm-search-btn" aria-pressed="false" tabindex="0"><span class="hide-offscreen">Show </span>Search<span class="icon icon-nav-search">
|
||
</span></button>
|
||
<div class="top-1">
|
||
<!-- Search
|
||
================================================== -->
|
||
<form target="_self" title="Search MedlinePlus" action="//vsearch.nlm.nih.gov/vivisimo/cgi-bin/query-meta" method="get" id="mplus-search">
|
||
<input type="hidden" value="medlineplus" name="v:project"/>
|
||
<input type="hidden" value="medlineplus-bundle" name="v:sources"/>
|
||
<div class="form-box text-combo">
|
||
<div class="form-area"><label for="searchtext_primary" class="hide-offscreen">Search MedlinePlus</label>
|
||
<span role="status" aria-live="polite" class="ui-helper-hidden-accessible">
|
||
</span><input type="text" aria-haspopup="true" aria-autocomplete="list" role="textbox" autocomplete="off" name="query" size="40" maxlength="400" title="Site Search input" alt="Site Search input" placeholder="Search MedlinePlus" class="form-text ui-autocomplete-input" id="searchtext_primary"/>
|
||
</div>
|
||
<div class="button-area">
|
||
<button type="submit" alt="Search MedlinePlus" title="Search MedlinePlus" class="form-btn">GO</button>
|
||
</div>
|
||
</div>
|
||
</form>
|
||
<!-- Secondary Nav
|
||
================================================== -->
|
||
<div class="secondarynav">
|
||
<ul class="nav-list">
|
||
<li><a href="https://medlineplus.gov/about/"><span>About MedlinePlus</span></a></li>
|
||
<li><a href="https://medlineplus.gov/whatsnew/"><span>What's New</span></a></li>
|
||
<li><a href="https://medlineplus.gov/sitemap.html"><span>Site Map</span></a></li>
|
||
<li><a target="_blank" href="https://support.nlm.nih.gov/knowledgebase/category/?id=CAT-01231&category=medlineplus&from=//medlineplus.gov/ency/article/007626.htm"><span>Customer Support</span></a></li>
|
||
</ul>
|
||
</div>
|
||
</div>
|
||
<!-- Nav Bar
|
||
================================================== -->
|
||
<div id="mplus-nav-bar">
|
||
<ul class="nav-list">
|
||
<li><a href="https://medlineplus.gov/healthtopics.html">Health Topics</a></li><li><a href="https://medlineplus.gov/druginformation.html">Drugs & Supplements</a></li><li><a href="https://medlineplus.gov/genetics/">Genetics</a></li><li><a href="https://medlineplus.gov/lab-tests/">Medical Tests</a></li><li><a href="https://medlineplus.gov/encyclopedia.html">Medical Encyclopedia</a></li>
|
||
</ul>
|
||
</div>
|
||
<a title="Español" id="mplus-lang-toggle" href="../../spanish/ency/article/007626.htm">Español</a>
|
||
</div>
|
||
</div>
|
||
</header>
|
||
<!-- Content
|
||
================================================== -->
|
||
<div id="mplus-content">
|
||
<!-- Breadrcumbs -->
|
||
<div id="breadcrumbs"><div itemtype="http://schema.org/BreadcrumbList" itemscope="" itemprop="breadcrumb"><span class="hide-offscreen">You Are Here:</span>
|
||
<div itemscope itemprop="itemListElement" itemtype="http://schema.org/ListItem">
|
||
<a href="https://medlineplus.gov" itemprop="item"><span itemprop="name">Home</span></a>
|
||
→
|
||
<meta itemprop="position" content="1"/>
|
||
</div>
|
||
|
||
<div itemscope itemprop="itemListElement" itemtype="http://schema.org/ListItem">
|
||
<a href="https://medlineplus.gov/encyclopedia.html" itemprop="item"><span itemprop="name">Medical Encyclopedia</span></a>
|
||
→
|
||
<meta itemprop="position" content="2"/>
|
||
</div>
|
||
</div><div><span>Sternal exploration or closure</span></div></div>
|
||
<span class="page-url print-only">URL of this page: //medlineplus.gov/ency/article/007626.htm
|
||
</span>
|
||
<!-- Article -->
|
||
<article><div id="d-article"><div class="page-info"><div class="page-title"><a name="start" id="start">
|
||
</a><h1 class="with-also" itemprop="name">Sternal exploration or closure</h1>
|
||
</div><div class="page-actions">
|
||
</div>
|
||
<noscript>
|
||
<span class="js-disabled-message">To use the sharing features on this page, please enable JavaScript.</span>
|
||
</noscript></div><div class="main"><div id="ency_summary"><p>When you have <a test="test" href="./002950.htm">open heart surgery</a>, the surgeon may make a cut (incision) that runs down the middle of your chest bone (sternum). The incision usually heals on its own after it is repaired. But sometimes, there are complications that require treatment.</p><p>Two wound complications that can happen within 30 days of open heart surgery are:</p><ul><li>Infection in the wound or chest bone. The symptoms can be pus at the incision, a fever, or feeling tired and sick.</li><li>The sternum separates into two. The sternum and chest become unstable. You might hear a clicking sound in the sternum when breathing, coughing, or moving around. </li></ul></div><section><div class="section"><div class="section-header"><div class="section-title"><h2>Description</h2></div><div class="section-button"><button type="submit" aria-controls="section-1" role="button" title="Expand/Collapse section"><span class="icon icon-section-action">
|
||
</span></button></div><div class="sm-live-area hide-offscreen" aria-live="polite">
|
||
</div></div><div class="section-body" id="section-1"><p>To treat the complication, the surgeon reopens the area that was operated on. The procedure is done in the operating room. The surgeon:</p><ul><li>Removes the wires holding the sternum together.</li><li>Does tests of the skin and tissue in the wound to look for signs of infection.</li><li>Removes dead or infected tissue in the wound (debride the wound). The breast bone may be removed.</li><li>Rinses the wound with salt water (saline). </li></ul><p>After the wound is cleaned out, the surgeon may or may not close the wound. The wound is packed with a dressing. The dressing will need to be changed daily.</p><p>Or your surgeon may use a VAC (vacuum-assisted closure) dressing. It is a negative pressure dressing. It increases blood flow around the sternum and improves healing.</p><p>The parts of VAC dressing are:</p><ul><li>Vacuum pump</li><li>Foam piece cut to fit the wound</li><li>Vacuum tube</li><li>Clear dressing that is taped on top </li></ul><p>The foam piece is changed every 2 to 3 days.</p><p>Your surgeon may put a chest harness on you. This will make the chest bones more stable.</p><p>It may take days, weeks, or even months for the wound to be clean, clear of infection, and finally heal.</p><p>Once this healing occurs, the surgeon may use wire to bring the bone back together then close the skin or use a muscle flap to cover and close the wound. The flap can be taken from your buttocks, shoulder, or upper chest.</p></div></div></section><section><div class="section"><div class="section-header"><div class="section-title"><h2>Why the Procedure is Performed</h2></div><div class="section-button"><button type="submit" aria-controls="section-2" role="button" title="Expand/Collapse section"><span class="icon icon-section-action">
|
||
</span></button></div><div class="sm-live-area hide-offscreen" aria-live="polite">
|
||
</div></div><div class="section-body" id="section-2"><p>You may have already been receiving wound care or treatment and antibiotics.</p><p>There are two main reasons for doing exploration and closure procedures for the chest wound after heart surgery:</p><ul><li>Get rid of an infection</li><li>Stabilize the sternum and chest</li></ul></div></div></section><section><div class="section"><div class="section-header"><div class="section-title"><h2>Before the Procedure</h2></div><div class="section-button"><button type="submit" aria-controls="section-3" role="button" title="Expand/Collapse section"><span class="icon icon-section-action">
|
||
</span></button></div><div class="sm-live-area hide-offscreen" aria-live="polite">
|
||
</div></div><div class="section-body" id="section-3"><p>If the surgeon thinks you have an infection in your chest incision, the following is usually done:</p><ul><li>Samples are taken from the drainage, skin, and tissue.</li><li>A sample of the breastbone is taken for a <a test="test" href="./003416.htm">biopsy</a>.</li><li>Blood tests are done.</li><li>You'll be assessed for how well you are eating and getting nutrients.</li><li>You'll be given antibiotics.</li></ul></div></div></section><section><div class="section"><div class="section-header"><div class="section-title"><h2>After the Procedure</h2></div><div class="section-button"><button type="submit" aria-controls="section-4" role="button" title="Expand/Collapse section"><span class="icon icon-section-action">
|
||
</span></button></div><div class="sm-live-area hide-offscreen" aria-live="polite">
|
||
</div></div><div class="section-body" id="section-4"><p>You will likely spend at least a few days in the hospital. After that, you will either go:</p><ul><li>Home and follow-up with your surgeon. Nurses may come to your home to help with wound care.</li><li>To a nursing facility for further help recovering. </li></ul><p>At either place, you may receive <a test="test" href="../patientinstructions/000496.htm">antibiotics</a> for several weeks in your veins (<a test="test" href="./002383.htm">IV</a>) or by mouth.</p></div></div></section><section><div class="section"><div class="section-header"><div class="section-title"><h2>Outlook (Prognosis)</h2></div><div class="section-button"><button type="submit" aria-controls="section-5" role="button" title="Expand/Collapse section"><span class="icon icon-section-action">
|
||
</span></button></div><div class="sm-live-area hide-offscreen" aria-live="polite">
|
||
</div></div><div class="section-body" id="section-5"><p>These complications can cause problems such as:</p><ul><li>A weakened chest wall</li><li>Long-term (chronic) pain</li><li>Decreased lung function</li><li>Increased risk of death</li><li>More infections</li><li>Need to repeat or revise the procedure </li></ul></div></div></section><section><div class="section"><div class="section-header"><div class="section-title"><h2>Alternative Names</h2></div><div class="section-button"><button type="submit" aria-controls="section-Alt" role="button" title="Expand/Collapse section"><span class="icon icon-section-action">
|
||
</span></button></div><div class="sm-live-area hide-offscreen" aria-live="polite">
|
||
</div></div><div class="section-body" id="section-Alt"><p>VAC - vacuum-assisted closure - sternal wound; Sternal dehiscence; Sternal infection</p></div></div></section><section><div class="section"><div class="section-header"><div class="section-title"><h2>References</h2></div><div class="section-button"><button type="submit" aria-controls="section-Ref" role="button" title="Expand/Collapse section"><span class="icon icon-section-action">
|
||
</span></button></div><div class="sm-live-area hide-offscreen" aria-live="polite">
|
||
</div></div><div class="section-body" id="section-Ref"><p>Lazar HL, Salm TV, Engelman R, Orgill D, Gordon S. Prevention and management of sternal wound infections. <em>J Thorac Cardiovasc Surg</em>. 2016;152(4):962-972. PMID: 27555340 <a href="https://pubmed.ncbi.nlm.nih.gov/27555340/" target="_blank">pubmed.ncbi.nlm.nih.gov/27555340/</a>.</p><p>Yepuri N, Pruekprasert N, Cooney RN. Surgical complications. In: Townsend CM Jr, Beauchamp RD, Evers BM, Mattox KL, eds. <em>Sabiston Textbook of Surgery</em>. 21st ed. St Louis, MO: Elsevier; 2022:chap 12. </p></div></div></section>
|
||
<section><div class="section"><div class="section-header"><div class="section-title"><h2>Review Date 7/16/2024</h2></div><div class="section-button"><button type="submit" aria-controls="section-version" role="button" title="Expand/Collapse section"><span class="icon icon-section-action">
|
||
</span></button></div><div class="sm-live-area hide-offscreen" aria-live="polite">
|
||
</div></div>
|
||
<div id="section-version" class="section-body"><p>Updated by: Mary C. Mancini, MD, PhD, Cardiothoracic Surgeon, Shreveport, LA. Review provided by VeriMed Healthcare Network. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.</p>
|
||
</div></div></section><section><div class="section ency-citation"><div class="section-header"><div class="section-title ency-citation"><div id="citation-how-to"><button><span>Learn how to cite this page</span></button></div></div><div class="sm-live-area hide-offscreen" aria-live="polite">
|
||
</div></div></div></section><section><div class="section sec-mb"><div class="section-header"><div class="section-title"><h2>Related MedlinePlus Health Topics</h2></div><div class="section-button"><button type="submit" aria-controls="section-mtp" role="button" title="Expand/Collapse section"><span class="icon icon-section-action">
|
||
</span></button></div><div class="sm-live-area hide-offscreen" aria-live="polite">
|
||
</div></div><div name="Related MedlinePlus Health Topics" class="section-body" id="section-mtp"><ul class="side-nav"><li><a href="https://medlineplus.gov/heartsurgery.html">Heart Surgery</a></li>
|
||
<li><a href="https://medlineplus.gov/woundsandinjuries.html">Wounds and Injuries</a></li>
|
||
|
||
</ul></div></div></section></div></div></article>
|
||
</div>
|
||
<footer>
|
||
|
||
<div class="provider-box group">
|
||
<div class="urac-logo">
|
||
<a href="https://accreditnet.urac.org/directory/#/certification/HCP-2/info"><img src="https://medlineplus.gov/images/CertifiedSeal.png"/></a>
|
||
<p class="urac-logo-info">Health Content Provider<br>06/01/2025</p>
|
||
</div>
|
||
<p class="adam-info">
|
||
<a href='javascript:urac_open();'>A.D.A.M., Inc. is accredited by URAC</a>, for Health Content Provider (www.urac.org). URAC's <a href='javascript:hwsopen();'>accreditation program</a> is an independent audit to verify that A.D.A.M. follows rigorous standards of quality and accountability. A.D.A.M. is among the first to achieve this important distinction for online health information and services. Learn more about A.D.A.M.'s <a href='javascript:edpolopen();'>editorial policy, editorial process</a>, and <a href='javascript:ppopen();'>privacy policy</a>. A.D.A.M. is also a founding member of Hi-Ethics. This site complies with the HONcode standard for trustworthy health information: <a href='javascript:honc_open();'>verify here</a>.
|
||
</p>
|
||
</div>
|
||
<p class="adam-info">
|
||
The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed medical professional should be consulted for diagnosis and treatment of any and all medical conditions. Links to other sites are provided for information only – they do not constitute endorsements of those other sites. No warranty of any kind, either expressed or implied, is made as to the accuracy, reliability, timeliness, or correctness of any translations made by a third-party service of the information provided herein into any other language. © 1997-2025 A.D.A.M., a business unit of Ebix, Inc. Any duplication or distribution of the information contained herein is strictly prohibited.
|
||
</p>
|
||
<div class="adam-logo">
|
||
<a href="https://www.adam.com/about" target="_blank"><img width="49" height="10" alt="About A.D.A.M." src="https://medlineplus.gov/ency/images/ency/ftrAdamlogo.gif"/></a>
|
||
</div>
|
||
<div id="mplus-footer">
|
||
<div class="footer1">
|
||
<ul class="secondarynav">
|
||
<li><a href="https://medlineplus.gov/about/">About MedlinePlus</a></li>
|
||
<li><a href="https://medlineplus.gov/whatsnew/">What's New</a></li>
|
||
<li><a href="https://medlineplus.gov/sitemap.html">Site Map</a></li>
|
||
<li><a name="contact" target="_blank" href="https://support.nlm.nih.gov/knowledgebase/category/?id=CAT-01231&category=medlineplus&from="><span>Customer Support</span></a></li>
|
||
</ul>
|
||
<ul class="follow-footer">
|
||
<li><a href="https://medlineplus.gov/rss.html" class="follow-item">Subscribe to RSS<img src="https://medlineplus.gov/images/feed.png" class="social-media-toolkit-icon" alt="RSS" title="RSS"></a></li>
|
||
<li><span class="follow-label">Follow us</span>
|
||
<a href="https://twitter.com/medlineplus" class="follow-item" target="_blank"><img src="https://medlineplus.gov/images/i_share_twitter.png" class="follow-icon" alt="X" title="X"></a>
|
||
<a href="https://facebook.com/Mplus.gov/" class="follow-item" target="_blank"><img src="https://medlineplus.gov/images/i_share_fb.png" class="follow-icon" alt="Facebook" title="Facebook"></a>
|
||
<a href="https://www.instagram.com/mplusgov/" class="follow-item" target="_blank"><img src="https://medlineplus.gov/images/Instagram_Glyph_Gradient_RGB.png" class="follow-icon" alt="Instagram" title="Instagram"></a>
|
||
</li>
|
||
<li><a href="https://medlineplus.gov/social-media-toolkit/" class="social-media-toolkit-item">Social Media Toolkit<img src="https://medlineplus.gov/images/i_social_media_toolkit.png" class="social-media-toolkit-icon" alt="Social Media Toolkit" title="Social Media Toolkit"></a></li>
|
||
</ul>
|
||
</div>
|
||
<div class="footer2">
|
||
<ul>
|
||
<li><a href="https://www.nlm.nih.gov/web_policies.html" target="_blank">NLM Web Policies</a></li>
|
||
<li><a href="https://medlineplus.gov/about/using/usingcontent/" >Copyright</a></li>
|
||
<li><a href="//medlineplus.gov/accessibility.html">Accessibility</a></li>
|
||
<li><a href="https://medlineplus.gov/about/using/criteria/">Guidelines for Links</a></li>
|
||
<li><a href="//medlineplus.gov/plugins.html">Viewers & Players</a></li>
|
||
<li><a href="https://www.hhs.gov/vulnerability-disclosure-policy/index.html" target="_blank">HHS Vulnerability Disclosure</a></li>
|
||
<li><a href="https://medlineplus.gov/medlineplus-connect/">MedlinePlus Connect for EHRs</a></li>
|
||
<li><a href="https://medlineplus.gov/about/developers/">For Developers</a></li>
|
||
</ul>
|
||
<div class="address">
|
||
<a href="//www.nlm.nih.gov" target="_blank">National Library of Medicine</a>
|
||
<span>8600 Rockville Pike, Bethesda, MD 20894</span>
|
||
<a href="//www.hhs.gov" target="_blank">U.S. Department of Health and Human Services</a>
|
||
<a href="//www.nih.gov" target="_blank">National Institutes of Health</a>
|
||
</div>
|
||
<div class="return-top"><a href="#top" title="Return to top"><img class="return-top-icon" alt="Return to top" src="https://medlineplus.gov/images/return-top.png"></a></div>
|
||
</div>
|
||
</div>
|
||
|
||
</footer>
|
||
</div><!-- End Wrap -->
|
||
<script src="https://medlineplus.gov/jslib/jquery-3.6.0.min.js" type="text/javascript">
|
||
</script>
|
||
<script src="https://medlineplus.gov/jslib/mplus-frontend-controls.js" type="text/javascript">
|
||
</script>
|
||
<!--[if lte IE 9]>
|
||
<script src="https://medlineplus.gov/jslib/jquery.placeholder.js" type="text/javascript"></script>
|
||
<![endif]-->
|
||
<script src="https://medlineplus.gov/jslib/mplus-share.js?id=1112022" type="text/javascript">
|
||
</script>
|
||
<script src="https://medlineplus.gov/jslib/control.js" type="text/javascript">
|
||
</script>
|
||
<script src="https://medlineplus.gov/uswds/js/uswds.min.js" type="text/javascript">
|
||
</script>
|
||
<script src="https://medlineplus.gov/jslib/ency/ency.js" type="text/javascript">
|
||
</script>
|
||
</body>
|
||
</html> |