Sternal wound infections: improvements made to reduce rates

Abstract

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.

Management of Sternal Wounds by Limited Debridement and Partial Bilateral Pectoralis Major Myocutaneous Advancement Flaps in 25 Patients

“…1Y17 These infections are potentially life threatening and often result in significant morbidity and revenue loss. 18,19 The current standard of care is debridement and immediate closure with muscle or myocutaneous flaps. 20Y36 Pectoralis major, rectus abdominis, and latissimus dorsi muscle flaps are most commonly used.…”