Drainage days—an independent risk factor for serious sternal wound infections after cardiac surgery: A case control study

Tschudin‐Sutter, Sarah; Meinke, Ruth; Schuhmacher, Heinz; Dangel, Marc; Eckstein, Friedrich S.; Reuthebuch, Oliver; Widmer, Andreas F.

doi:10.1016/j.ajic.2013.03.311

Cited by 7 publications

(9 citation statements)

References 29 publications

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“…Considerable advantages of the digital drainage system are its portability and earlier removal of the drains. This could have major implications for postoperative recovery and rehabilitation efforts in patients, including greater opportunities to engage in physical activity and a risk reduction in sternal wound infections (30).…”

Section: Discussionmentioning

confidence: 99%

Reduction of drainage-associated complications in cardiac surgery with a digital drainage system: a randomized controlled trial

et al. 2019

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Background: Thoracic chest drains are placed after cardiac surgery allowing for the clearance of blood, fluid, and air to prevent post-operative complications. Despite its importance, there is little data on the application of digital chest drainage systems in cardiac surgery. Therefore, the differences between an analog and a digital chest drainage system in cardiac surgery patients were investigated in a randomized controlled trial. Methods: A total of 354 elective cardiac surgery patients were preoperatively randomized 1:1 between September 2016 and September 2017 to either an analog (Ocean) or a digital (Thopaz + ) chest drainage system aiming to compare drainage-associated postoperative outcome parameters.Results: A total of 340 patients were included in the analysis (analog: 188; digital: 152) with no significant differences in preoperative baseline parameters. Incidence of X-rays to detect air leaks was significantly lower in the digital group (analog: 20.2%; digital: 8.6%; P<0.01). Patients treated with the digital system showed a 3.3% reduction of re-thoracotomies, however, not statistically significant (analog: 5.3%; digital: 2.0%; P=0.19). Median total fluid amount did not significantly differ between study groups [median (P25; P75); analog: 705 (400; 1,333) mL; digital: 686 (404; 1,229) mL; P=0.83]; however, the use of the digital drainage system resulted in a quicker removal with a reduced median drainage duration of 16 hours (analog: 65 hours; digital: 49 hours; P≤0.01). Conclusions:The study provides evidence that digital drainage systems can be safely applied in cardiac surgery patients. The use of the digital management system led to a decreased incidence of drainageassociated complications as well as to shortened chest tube duration. Findings require confirmation by additional studies.

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Section: Discussionmentioning

confidence: 99%

Reduction of drainage-associated complications in cardiac surgery with a digital drainage system: a randomized controlled trial

et al. 2019

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“…Eight of the 13 studies that analyzed sternal infection focused on risk factors for deep sternal wound infection, and the remaining five reported predictors for superficial and deep sternal wound infections, individually or as a collective [25][26][27][28][29][30][31][32][33][34][35][36][37]. Most studies based their diagnosis on the Centers for Disease Control and Prevention's definition for surgical site infection, although studies by Zacharias and Habib (1996) [25], Antunes and colleagues (1997) [26], and Wenger and colleagues (1998) [28] provided their own definitions, drawing on the presence of clinical signs and symptoms of sternal infection.…”

Section: Risk Factors For Sternal Infectionmentioning

confidence: 99%

“…Most studies based their diagnosis on the Centers for Disease Control and Prevention's definition for surgical site infection, although studies by Zacharias and Habib (1996) [25], Antunes and colleagues (1997) [26], and Wenger and colleagues (1998) [28] provided their own definitions, drawing on the presence of clinical signs and symptoms of sternal infection. Seven independent risk factors for sternal infection were reported by more than one study and are described in further detail below [25][26][27][28][29][30][31][32][33][34][35][36][37].…”

Section: Risk Factors For Sternal Infectionmentioning

confidence: 99%

Risk Factors for Sternal Complications After Cardiac Operations: A Systematic Review

Balachandran

Lee

Denehy

et al. 2016

The Annals of Thoracic Surgery

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Early detection of patients at risk of sternal complications is essential to facilitate prevention and optimize timely intervention. A systematic review and meta-analysis was conducted to identify risk factors associated with sternal complications. The review included 17 full-text studies, of which 10 were entered into meta-analyses. Female gender, diabetes mellitus, obesity, bilateral internal mammary artery grafts, reoperation for postoperative complications, and blood product requirement were reported as significant predictors of sternal infection. The compilation of these risk factors may help to screen and stratify patients at risk of impaired sternal healing and warrants further investigation.

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“…However, surgical drain itself can also be a risk factor for SSI [7]. Indeed, many studies have found an association between the presence of surgical drainage and SSI or between the drainage duration and the proportion of SSI [7,8,9]. Systematic cultures of drain tips or drainage fluids are commonly used by surgical teams for the early detection of SSI, even in the absence of clinical suspicion of infection.…”

Section: Introductionmentioning

confidence: 99%

Drain Tip Culture: Would It Help Us Predict and Prevent Surgical Site Infection After Spinal Surgery?

2021

BBJ

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Background: Systematic cultures of drain tips or drainage fluids are commonly used by surgical teams for the early detection of Surgical Site Infection (SSI), even in the absence of clinical suspicion of infection. However, their prognostic values are controversial. Method: This was a prospective study of patients undergoing spine surgery at our institute during the study period. Patients already diagnosed with spine infection were excluded from the study. At the time of drain removal, the drain tip was cut and sent to microbiology laboratory for bacterial culture. All patients were treated with antimicrobial prophylaxis based on evidence-based guidelines and were monitored for at least 6 months after surgery for the development of Surgical Site Infection (SSI). SSI was defined according to Centers for Disease Control and Prevention criteria. Results: The study comprised of 183 patients including 85 males and 98 females. The rate of Surgical Site Infection in our study was 2.73 % (5 patients). Drain Tip Culture (DTC) was positive in 4 patients (2.18 %). Association of DTC with SSI was found to have high Specificity (98.31 %) and Negative Predictive Value (97.76 %) but low Sensitivity (20 %) and Positive Predictive Value (25 %). Conclusion: Culture of drain tip after spine surgery does not conclusively predict the presence or absence of surgical site infection. However, statistical significance was observed between drain tip culture and surgical site infection with high specificity, high negative predictive value, low sensitivity and low positive predictive value. Keywords: Drain tip culture; Spinal Surgery; Surgical site infection.

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Drainage days—an independent risk factor for serious sternal wound infections after cardiac surgery: A case control study

Cited by 7 publications

References 29 publications

Reduction of drainage-associated complications in cardiac surgery with a digital drainage system: a randomized controlled trial

Reduction of drainage-associated complications in cardiac surgery with a digital drainage system: a randomized controlled trial

Risk Factors for Sternal Complications After Cardiac Operations: A Systematic Review

Drain Tip Culture: Would It Help Us Predict and Prevent Surgical Site Infection After Spinal Surgery?

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