Postoperative Wound Infections Following Cardiac Surgery: Significance of Contaminated Cases Performed in the Preceding 48 Hours

Abstract

Postoperative wound infections following open heart cardiac surgery increased markedly after hospital relocation (7 of 77 v; 4 of 320; p = .0007). Of the multiple identified risk factors, significant patient and procedural association included prolonged operative time of infected patients (384 minutes ± 115 SD v 318 ± 67, p = .025) and operation in a room used within the previous 48 hours for a contaminated case (4/7 infected v 10/67 not infected; p = .023). Several defects were discovered in the air handling system. After appropriate changes, the infection rate decreased in the next 12 months (1 of 109; p < .02). Other concurrent surgical wound infection rates remained unchanged suggesting that defective air handling may have impacted only on the open heart cardiac surgery patients. Preceding contaminated surgery and prolonged operative time were associated with postoperative wound infections in cardiac surgery.

Risk Factors for Infection in Cardiac Surgery: Will the Real Culprit Please Stand Up?

“…In the study by de Silva and Rissing, 9% of patients developed postoperative wound infection following cardiac surgery during the first six months after a relocation to a new facility. 2 Performing cardiac surgery in a room used within the past 48 hours for a "contaminated" case was statistically associated with increased wound infections. In the study by Dandalides, Ratula, and Sarubbi, 23.7% of patients undergoing cardiac surgery developed a postoperative wound or nonwound infection during a two-month period in 1981. :i An extensive epidemiologic and microbiologic study of the cardiothoracic intensive care unit was undertaken.…”