An approach to improve early detection of sternal wound infection

Howlader, M.; Smith, John E E; Madden, Brendan

doi:10.3329/bmrcb.v35i1.1815

Cited by 4 publications

(3 citation statements)

References 10 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…In our study, 62 (59) patients from the SWI group were assigned an ASA score of IV. One percent of patients who have median sternotomy develop SSWI usually 7–9 days after the operation [ 6 ]. In our study, 2.4% the patients developed SSWI usually 7–9 days post-operatively.…”

Section: Discussionmentioning

confidence: 99%

“…In our study, 2.4% the patients developed SSWI usually 7–9 days post-operatively. DSWI usually presents 2–4 weeks after an operation, but can present months or years later [ 6 ]. Among the 164 patients enrolled in this study, 107 (65.2%) developed DSWI.…”

Section: Discussionmentioning

confidence: 99%

“…The incidence of deep sternal wound infection (DSWI), despite advances in prevention, still remains significant, and ranges between 0.5% and 6.8% [ 3 – 5 ], with in-hospital mortality rates between 7% and 47% [ 3 – 5 ]. In many cases, traditional markers of infection such as fever, leucocytosis and C-reactive protein (CRP) have proved unreliable [ 6 ]. Some patients require further surgery, including repeated debridement and major surgical reconstruction.…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Sternal wound infections following cardiac surgery and their management: a single-centre study from the years 2016–2017

Kotnis-Gąska¹,

Mazur²,

Olechowska-Jarząb³

et al. 2018

kitp

View full text Add to dashboard Cite

IntroductionDespite improvements in surgical management, sternal wound infection (SWI) following cardiac surgery remains a significant complication.AimTo evaluate pathogens involved in SWI following median sternotomy.Material and methodsWe enrolled 164 patients who experienced prolonged sternal wound healing following open-heart surgery. The inclusion criteria were as follows: prolonged sternal wound healing following cardiac surgery via median sternotomy and complete results of microbiological culture obtained from the sternal swab. The exclusion criteria were as follows: partial sternotomy, patients with mechanical sternum dehiscence and incomplete clinical data. Swabs provided information on the type of microorganism present in the wound and the susceptibility of the microorganism to specific antibiotics.ResultsOne hundred and fourteen (69.5%) patients aged 68 (interquartile range: 60–76) years developed SWI with positive culture. The in-hospital mortality rate was 21.0% in this group. The most common pathogens included Staphylococcus epidermidis (26.6%), Enterococcus faecium (12.2%), Staphylococcus aureus (11.4%), Klebsiella pneumoniae (8.4%), and Pseudomonas aeruginosa (6.8%). In most of the cases the isolated Staphylococcus epidermidis was methicillin-resistant (n = 57, 43.5%). Enterococcus faecium was vancomycin-resistant in 11 (8.3%) cases and high-level aminoglycoside resistant (HLAR) in 13 (9.9%) cases. Klebsiella pneumoniae had the extended-spectrum β-lactamase (ESBL) mechanism in 14 (10.6%) cases. Among 114 culture-positive patients, 48 (42.1%) had polymicrobial infection of the sternal wound.ConclusionsMicroorganisms associated with SWI in our study were mainly commensals, with the most common pathogen being Staphylococcus epidermidis.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Sternal wound infections following cardiac surgery and their management: a single-centre study from the years 2016–2017

Kotnis-Gąska¹,

Mazur²,

Olechowska-Jarząb³

et al. 2018

kitp

View full text Add to dashboard Cite

show abstract

Sternal Precautions: Is It Time for Change? Precautions versus Restrictions - A Review of Literature and Recommendations for Revision

Cahalin

LaPier

Shaw

2011

Cardiopulmonary Physical Therapy Journal

View full text Add to dashboard Cite

Sternal wound infections: improvements made to reduce rates

Aziz

Isalska²

2010

Br J Nurs

View full text Add to dashboard Cite

Wound infections from surgical sites account for 15% of all healthcare-associated infections (National Institute for Health and Clinical Excellence (NICE), 2008). There is evidence that the care provided before and after the operation is paramount to minimize the risk of surgical site infection. Sternal wound infections lengthen hospital stays (or prompt readmission) and carry a high mortality rate. In August 2009 a Manchester Hospital discovered a cluster of three patients with sternal wound infections. A review of clinical data for patients having cardiac surgery from 1 December 2008 and 9 October 2009 revealed an increased incidence of patients with sternal wound infections. The data did not reveal a significant problem, but one that should be kept under observation. During the investigation no single pathogen had been identified as responsible and no obvious source of environmental infection was identified. Implementing additional infection prevention and control practices helped the hospital team to improve the care given to patients. A host of factors, ranging from providing more information on wound care to patients, improving audit scores, and adhering to NICE guidelines, contributed to the reduction in this type of surgical site infection.

show abstract

An approach to improve early detection of sternal wound infection

Cited by 4 publications

References 10 publications

Sternal wound infections following cardiac surgery and their management: a single-centre study from the years 2016–2017

Sternal wound infections following cardiac surgery and their management: a single-centre study from the years 2016–2017

Sternal Precautions: Is It Time for Change? Precautions versus Restrictions - A Review of Literature and Recommendations for Revision

Sternal wound infections: improvements made to reduce rates

Contact Info

Product

Resources

About