Surgical-Site Infection Rates and Risk Factor Analysis in Coronary Artery Bypass Graft Surgery

Harrington, Glenys; Russo, Philip L.; Spelman, Denis; Borrell, Sue; Watson, Kerrie; Barr, Wendy; Martin, Rhea; Edmonds, Diedre; Cocks, J.; Greenbough, John; Lowe, J.; Randle, Leesa; Castell, J; Browne, Elizabeth; Bellis, Kaye; Aberline, Melissa

doi:10.1086/502424

Cited by 149 publications

(93 citation statements)

References 17 publications

(11 reference statements)

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“…The presence of diabetes as an independent predictor of development of any infection in post-CABG was demonstrated in this study, in agreement with previous reports [7,24,28]. We did not observe, however, the association between age, obesity [7,14,20], females [28,29] and presence of hypertension [29] with the development of infection, described in other series.…”

Section: Discussionsupporting

confidence: 93%

“…Specifically, the number of patients who developed deep wound infection was similar to that observed in other studies [7,8,14,[17][18][19][20][21], with some exceptions [22][23][24]. The expectation that new preventive and therapeutic approaches focusing on the prevention of surgical infection could reduce the incidence of infections over the past years did not occur in most of the studies cited, probably because more patients that underwent CABG during that period were elderly of high surgical risk and higher surgical complexity [25].…”

Section: Discussionsupporting

confidence: 87%

“…We did not observe, however, the association between age, obesity [7,14,20], females [28,29] and presence of hypertension [29] with the development of infection, described in other series. Longer duration of central venous catheter and cardiac catheterization during hospitalization as independent predictors of development of any infection in the postoperative period of CABG were shown only in our study, regardless of the presence of DM they retained their association with the risk of infection.…”

Section: Discussioncontrasting

confidence: 83%

“…Treatment for coronary artery bypass graft (CABG) has been shown to improve survival in patients with severe coronary artery disease [1]. However, several studies have shown, after heart surgery, still significant rate of postoperative complications, especially superficial and shallow infections [2][3][4][5][6][7][8]. A multicenter study conducted in Australia showed that of 4,474 patients undergoing CABG, the risk of wound infection was 4.5 to 10.7 per 100 procedures.…”

Section: Introductionmentioning

confidence: 99%

“…A multicenter study conducted in Australia showed that of 4,474 patients undergoing CABG, the risk of wound infection was 4.5 to 10.7 per 100 procedures. Multivariate analysis showed age, obesity and diabetes mellitus (DM) as independent risk factors for this outcome [7]. In relation to DM, Guven et al [9] demonstrated that hyperglycemia at pre-CABG was the main risk factor for developing post-operative infections; risk can be reduced with improved glycemic control in the perioperative period [10].…”

Section: Introductionmentioning

confidence: 99%

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Preditores de infecção no pós-operatório de cirurgia de revascularização miocárdica

Ledur¹,

Almeida²,

Pellanda³

et al. 2011

Rev Bras Cir Cardiovasc

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Section: Discussionsupporting

confidence: 93%

Section: Discussionsupporting

confidence: 87%

Section: Discussioncontrasting

confidence: 83%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Preditores de infecção no pós-operatório de cirurgia de revascularização miocárdica

Ledur¹,

Almeida²,

Pellanda³

et al. 2011

Rev Bras Cir Cardiovasc

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show abstract

Sustained Reduction in Methicillin-Resistant Staphylococcus aureus Wound Infections After Cardiothoracic Surgery

Walsh

Greene²,

Kirshner³

2010

Arch Intern Med

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Surgical Site Infection Prevention

Seidelman

Mantyh

Anderson

2023

JAMA

164

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ImportanceApproximately 0.5% to 3% of patients undergoing surgery will experience infection at or adjacent to the surgical incision site. Compared with patients undergoing surgery who do not have a surgical site infection, those with a surgical site infection are hospitalized approximately 7 to 11 days longer.ObservationsMost surgical site infections can be prevented if appropriate strategies are implemented. These infections are typically caused when bacteria from the patient’s endogenous flora are inoculated into the surgical site at the time of surgery. Development of an infection depends on various factors such as the health of the patient’s immune system, presence of foreign material, degree of bacterial wound contamination, and use of antibiotic prophylaxis. Although numerous strategies are recommended by international organizations to decrease surgical site infection, only 6 general strategies are supported by randomized trials. Interventions that are associated with lower rates of infection include avoiding razors for hair removal (4.4% with razors vs 2.5% with clippers); decolonization with intranasal antistaphylococcal agents and antistaphylococcal skin antiseptics for high-risk procedures (0.8% with decolonization vs 2% without); use of chlorhexidine gluconate and alcohol-based skin preparation (4.0% with chlorhexidine gluconate plus alcohol vs 6.5% with povidone iodine plus alcohol); maintaining normothermia with active warming such as warmed intravenous fluids, skin warming, and warm forced air to keep the body temperature warmer than 36 °C (4.7% with active warming vs 13% without); perioperative glycemic control (9.4% with glucose &lt;150 mg/dL vs 16% with glucose &gt;150 mg/dL); and use of negative pressure wound therapy (9.7% with vs 15% without). Guidelines recommend appropriate dosing, timing, and choice of preoperative parenteral antimicrobial prophylaxis.Conclusions and RelevanceSurgical site infections affect approximately 0.5% to 3% of patients undergoing surgery and are associated with longer hospital stays than patients with no surgical site infections. Avoiding razors for hair removal, maintaining normothermia, use of chlorhexidine gluconate plus alcohol–based skin preparation agents, decolonization with intranasal antistaphylococcal agents and antistaphylococcal skin antiseptics for high-risk procedures, controlling for perioperative glucose concentrations, and using negative pressure wound therapy can reduce the rate of surgical site infections.

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Surgical-Site Infection Rates and Risk Factor Analysis in Coronary Artery Bypass Graft Surgery

Abstract: We documented aggregate and comparative SSI rates among five Victorian public hospitals performing CABG surgery and defined specific independent risk factors for SSI. VICSP data offer opportunities for targeted interventions to reduce SSI following cardiac surgery.

Cited by 149 publications

References 17 publications

Preditores de infecção no pós-operatório de cirurgia de revascularização miocárdica

Preditores de infecção no pós-operatório de cirurgia de revascularização miocárdica

Sustained Reduction in Methicillin-Resistant Staphylococcus aureus Wound Infections After Cardiothoracic Surgery

Surgical Site Infection Prevention

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