Wound Infection in Cardiac Surgery

Softah, Abdullateef; Hendry, Peter; Rg, Masters; Goldstein, Wayne M.; Brais, Maurice; Keon, Wilbert J.

doi:10.5144/0256-4947.2002.105

Cited by 12 publications

(13 citation statements)

References 16 publications

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“…72.1% of our SWI had positive wound culture, with S. aureus being the most common cause in both superficial and deep SWI, which chimes in with the results of similar research in the literature (33–70%) [ 4 , 5 , 7 , 8 ]. Positive blood culture was significantly higher in deep SWI than superficial SWI in our study (25% versus 4.3%, respectively).…”

Section: Discussionsupporting

confidence: 85%

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Superficial and deep sternal wound infection after more than 9000 coronary artery bypass graft (CABG): incidence, risk factors and mortality

et al. 2007

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BackgroundSternal wound infection (SWI) is an uncommon but potentially life-threatening complication of cardiac surgery. Predisposing factors for SWI are multiple with varied frequencies in different studies. The purpose of this study was to assess the incidence, risk factors, and mortality of SWI after coronary artery bypass grafting (CABG) at Tehran Heart Center.MethodsThis study prospectively evaluated multiple risk factors for SWI in 9201 patients who underwent CABG at Tehran Heart Center between January 2002 and February 2006. Cases of SWI were confirmed based on the criteria of the Centers for Disease Control and Prevention. Deep SWI (bone and mediastinitis) was categorized according to the Oakley classification.ResultsIn the study period, 9201 CABGs were performed with a total SWI rate of 0.47 percent (44 cases) and deep SWI of 0.22 percent (21 cases). Perioperative (in-hospital) mortality was 9.1% for total SWI and about 14% for deep SWI versus 1.1% for non-SWI CABG patients. Female gender, preoperative hypertension, high functional class, diabetes mellitus, obesity, prolonged intubation time (more than 48 h), and re-exploration for bleeding were significant risk factors for developing SWI (p = 0.05) in univariate analysis. In multivariate analysis, hypertension (OR = 10.7), re-exploration (OR = 13.4), and female gender (OR = 2.7) were identified as significant predictors of SWI (p < 0.05 for all). The rate of SWI was relatively similar in 3 groups of prophylactic antibiotic regimen (Cefazolin, Cefazolin + Gentamycin and Cefazolin + Amikacin: 0.5%, 0.5%, and 0.34% respectively).ConclusionRarely reported previously, the two risk factors of hypertension and the female gender were significant risk factors in our study. Conversely, some other risk factors such as cigarette smoking and age mentioned as significant in other reports were not significant in our study. Further studies are needed for better documentation.

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Section: Discussionsupporting

confidence: 85%

“…The rate of SWI varies in different reports. Softah et al reported 2.5% superficial and 0.37% deep sternal wound infection among 3200 patients [ 5 ].…”

Section: Discussionmentioning

confidence: 99%

Superficial and deep sternal wound infection after more than 9000 coronary artery bypass graft (CABG): incidence, risk factors and mortality

et al. 2007

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“…[1,5,[14][15][16][17] We found that over half of the patients (62.2%) in our study had suffered from a wound-related problem at least one of these symptoms (Table 1). Wound infections are not common in cardiac surgery with rates of infection varying between 1.9% and 15% from the area from where the saphenous vein was taken.…”

Section: Discussionmentioning

confidence: 97%

Postoperative problems experienced by patients undergoing coronary artery bypass graft surgery and their self-care ability after discharge

Direk¹,

Çelik²

2012

Turk Gogus Kalp Dama

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Postoperative problems experienced by patients undergoing coronary artery bypass graft surgery and their self-care ability after dischargeKoroner arter baypas greft cerrahisi yapılan hastaların taburcu edildikten sonra yaşadıkları sorunlar ve öz bakım yetileri Background:In this research, we aimed to assess the postoperative problems experienced by patients who underwent coronary artery bypass graft (CABG) surgery and their self-care ability after discharge.Methods: A total of 53 patients who underwent CABG surgery in the Cardiology Department of a state hospital affiliated with the Turkish Republic of Northern Cyprus Ministry of Health between September 2010 and February 2011 were included in this descriptive and crosssectional study. The data was collected using the "Personal Information" form, the "Problems Experienced by Patients after Discharge" form, and the Turkish version of the Exercise of Self-Care Agency (ESCA) Scale. Statistical analysis was performed using the SPSS version 15.0 software program. The Kruskal-Wallis and Mann-Whitney U tests were used to compare the frequency and distribution statistics. Results: Male participants made up 71.7% (n=38) of the study group while 43.4% (n=23) of the subects were primary school graduates, 83% (n=44) were married, 75.5% (n=40) were overweight, 45.3% (n=24) had undergone triple bypass surgery, and 84.9% (n=45) were connected to a heart-lung machine. After discharge, the patients reported fatigue, dyspnea, pain at the wound site, weakness, sleeplessness, loss of appetite, fear, pessimism, edema in the legs, wound dehiscence, palpitation, and constipation. When patients were asked how they handled these problems, 81.1% (n=43) stated that they simply waited until they were over, 71.7% (n=38) slept sitting up, 66% (n=35) took medication, and 15.1% (n=8) did breathing exercises. The mean selfcare ability score of the patients was 108.5±17, indicating that the patients had a moderate level of self-care ability. It was also found that these problems decreased over time. No statistically significant difference was found between the self-care ability scores and the problems experienced by the patients (p>0.05). Conclusion: It was found that all patients experienced at least one problem after discharge. Discharge education programs with an interdisciplinary perspective, and consultancy services in conjunction with home care and follow-up should be implemented with an improvement in quality so as to reduce and eliminate the problems faced by the patients.

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“…En una población de estudio mayor en número, el poder individual aumentaría en cada una de ellas, pudiendo ser evidenciadas con certeza estadística del mismo modo que la asociación existente entre infección y fallecimiento, donde el tamaño de muestra aumenta sustancialmente so- bre lo calculado para este estudio. Se ha estimado en ~14% la mortalidad asociada a los pacientes que desarrollan una mediastinitis [14][15][16] . La aplicabilidad del índice Toronto es viable, cuanto más si se efectúa contemporáneamente al evento y evolución quirúrgica.…”

Section: Discussionunclassified

Comportamiento de dos escalas predictoras de infección de herida operatoria en cirugía de bypass coronario: NNIS y Toronto en población chilena

2005

Rev. chil. infectol.

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A multicenter case-control pilot study was conducted (71/213) to know the predictive value of two risk scales for nosocomial wound infections, NNIS and Toronto score, applied to coronary artery bypass graft surgery in six hospitals in Santiago- Chile, from 1998 to 2002. A straight correlation of wound infection risk and Intensive Care Unit stay beyond three days, sub-group of the Toronto scale, was identified. Toronto scale, according to its four groups of clinical risk, is therefore an effective tool to adjust rates and make comparisons between hospitals that perform this type of surgery.

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Wound Infection in Cardiac Surgery

Cited by 12 publications

References 16 publications

Superficial and deep sternal wound infection after more than 9000 coronary artery bypass graft (CABG): incidence, risk factors and mortality

Superficial and deep sternal wound infection after more than 9000 coronary artery bypass graft (CABG): incidence, risk factors and mortality

Postoperative problems experienced by patients undergoing coronary artery bypass graft surgery and their self-care ability after discharge

Comportamiento de dos escalas predictoras de infección de herida operatoria en cirugía de bypass coronario: NNIS y Toronto en población chilena

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