Mediastinitis after cardiac surgery: risk factors and our vacuum-assisted closure results

Buğra, Abdul Kerim; Göde, Safa; Buğra, Aytül; Eltutan, Sefa; Arafat, Zeinab; Şen, Onur; Erentuğ, Vedat

doi:10.5114/kitp.2021.112184

Cited by 2 publications

(5 citation statements)

References 33 publications

(79 reference statements)

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“…The rest 26 and seven variables were synthesized (Table 3 ). The dichotomous variables were diabetes mellitus (DM), 1 , 2 , 3 , 8 , 9 , 10 , 11 , 12 , 13 , 14 , 15 , 16 , 17 , 18 , 19 , 20 , 21 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 , 43 , 44 , 45 , 46 , 47 , 48 , 49 , 50 , 51 , 52 , 53 , 54 , 56 , 57 , 58 , 59 ,…”

Section: Resultsmentioning

confidence: 99%

“…The dichotomous variables were diabetes mellitus (DM), 1–3,8–21,23–32,34–54,56–66,68–79,103,106–109 female gender, 1–3,9–21,23,24,26–32,34,36–65,67–76,78–80,103–109 emergent/urgent procedures,…”

Section: Resultsmentioning

confidence: 99%

“…The rest 26 and seven variables were synthesized (Table 3). The dichotomous variables were diabetes mellitus (DM), 1-3,8-21,23-32,34-54,56-66,68-79,103,106-109 female gender, 1-3,9-21,23,24,26-32,34,36-65,67-76,78-80,103-109 emergent/ urgent procedures, 1,3,10,13-17,20,21,23,27,28,30-32,35-38,41-44,48-51, 54-59,61-65,67,69-76,78-80,104-106 chronic obstructive pulmonary disease (COPD), 3,[8][9][10][13][14][15][16]18,20,21,23,25,[27][28][29][30][31][32][36][37][38][39][40][41][43][44][45][46][47][48][49]51,52,54,[57][58][59][61][62][63]67,[69][70][71]73,75,77,…”

Section: Investigated Variablesmentioning

confidence: 99%

“…This leads to prolonged hospital stays, incremental charges and great suffering 6,7 . To determine its aetiology and minimize its incidence, we reviewed related studies and found that a large number of researches, 1–3,8–109 including retrospective matched or unmatched case‐control and cohort studies, have been conducted to study the risk factors among possible variables directly or indirectly, most of which were classified as preoperative or baseline, intraoperative and postoperative variables. Dozens of them have been proven to be significant in univariate or multivariate analyses, and the latter have been identified as independent risk factors of SWI.…”

Section: Introductionmentioning

confidence: 99%

“… 5 This leads to prolonged hospital stays, incremental charges and great suffering. 6 , 7 To determine its aetiology and minimize its incidence, we reviewed related studies and found that a large number of researches, 1 , 2 , 3 , 8 , 9 , 10 , 11 , 12 , 13 , 14 , 15 , 16 , 17 , 18 , 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 , 43 , 44 , 45 , 46 , 47 , 48 , 49 , 50 , 51 , 52 , 53 , 54 , 55 , 56 …”

Section: Introductionmentioning

confidence: 99%

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Risk factors for sternal wound infection after open‐heart operations: A systematic review and meta‐analysis

Chen,

Zhang,

Wang

et al. 2023

International Wound Journal

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We aimed to quantitatively and systematically elucidate the rationality of the examined variables as independent risk factors for sternal wound infection. We searched databases to screen studies, ascertained the variables to be analysed, extracted the data and applied meta‐analysis to each qualified variable. Odds ratios and mean differences were considered to be the effect sizes for binary and continuous variables, respectively. A random‐effects model was used for these procedures. The source of heterogeneity was evaluated using a meta‐regression. Publication bias was tested by funnel plot and Egger's test, the significant results of which were then calculated using trim and fill analysis. We used a sensitivity analysis and bubble chart to describe their robustness. After screening all variables in the eligible literature, we excluded 55 because only one or no research found them significant after multivariate analysis, leaving 33 variables for synthesis. Two binary variables (age over 65 years, NYHA class >2) and a continuous variable (preoperative stay) were not significant after the meta‐analysis. The most robust independent risk factors in our study were diabetes mellitus, obesity, use of bilateral internal thoracic arteries, chronic obstructive pulmonary disease, prolonged surgery time, prolonged ventilation and critical preoperative state, followed by congestive heart failure, atrial fibrillation, renal insufficiency, stroke, peripheral vascular disease and use of an intra‐aortic balloon pump. Relatively low‐risk factors were emergent/urgent surgery, smoking, myocardial infarction, combined surgery and coronary artery bypass grafting. Sternal wound infection after open‐heart surgery is a multifactorial disease. The detected risk factors significantly affected the wound healing process, but some were different in strength. Anything that affects wound healing and antibacterial ability, such as lack of oxygen, local haemodynamic disorders, malnutrition condition and compromised immune system will increase the risk, and this reminds us of comprehensive treatment during the perioperative period.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Investigated Variablesmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Risk factors for sternal wound infection after open‐heart operations: A systematic review and meta‐analysis

Chen,

Zhang,

Wang

et al. 2023

International Wound Journal

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Surgical Site Infection in Cardiac Surgery

Żukowska¹,

Żukowski

2022

JCM

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Surgical site infections (SSIs) are one of the most significant complications in surgical patients and are strongly associated with poorer prognosis. Due to their aggressive character, cardiac surgical procedures carry a particular high risk of postoperative infection, with infection incidence rates ranging from a reported 3.5% and 26.8% in cardiac surgery patients. Given the specific nature of cardiac surgical procedures, sternal wound and graft harvesting site infections are the most common SSIs. Undoubtedly, DSWIs, including mediastinitis, in cardiac surgery patients remain a significant clinical problem as they are associated with increased hospital stay, substantial medical costs and high mortality, ranging from 3% to 20%. In SSI prevention, it is important to implement procedures reducing preoperative risk factors, such as: obesity, hypoalbuminemia, abnormal glucose levels, smoking and S. aureus carriage. For decolonisation of S. aureus carriers prior to cardiac surgery, it is recommended to administer nasal mupirocin, together with baths using chlorhexidine-based agents. Perioperative management also involves antibiotic prophylaxis, surgical site preparation, topical antibiotic administration and the maintenance of normal glucose levels. SSI treatment involves surgical intervention, NPWT application and antibiotic therapy

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Mediastinitis after cardiac surgery: risk factors and our vacuum-assisted closure results

Cited by 2 publications

References 33 publications

Risk factors for sternal wound infection after open‐heart operations: A systematic review and meta‐analysis

Risk factors for sternal wound infection after open‐heart operations: A systematic review and meta‐analysis

Surgical Site Infection in Cardiac Surgery

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