Factors predisposing to median sternotomy complications. Deep vs superficial infection.
نویسندگان
چکیده
STUDY OBJECTIVES Median sternotomy infections are a serious complication of cardiac surgery. The purpose of this study was to determine the patient characteristics and operative variables that predict incidence of sternal infection, and possibly its severity. DESIGN Univariate and multivariate retrospective analysis comparing patient, operative, and post-operative data in patients with and without sternal infections. SETTING Cardiac surgery program of a 580-bed private hospital in Toledo, Ohio. PATIENTS We studied 2,317 consecutive (June 1991 to December 1994) patients undergoing cardiac surgery. RESULTS Forty-one sternal infections were documented. Of these, 21 (0.91%) were deep infections with mediastinal involvement and 20 (0.86%) were superficial. Two patients with deep infections died (2/41, 5%). Ten variables were associated with infection by univariate analysis (p < 0.05), and of these, five were independent predictors by multivariate logistic regression. These predictors were obesity (p < 0.001), insulin-dependent diabetes (p < 0.001), use of internal mammary artery grafts (p = 0.02), surgical reexploration of the mediastinum (p = 0.003), and postoperative transfusions (p = 0.01). Predictors of deep and superficial sternal infection did not differ. Length of hospitalization was substantially longer for patients with deep (32 +/- 21 days) vs superficial infection (13 +/- 10 days). CONCLUSIONS The present study confirms previous findings that obesity, insulin-dependent diabetes, and internal mammary artery grafting (especially bilaterally) increase the risk of sternal infection. In addition, chest surgical reexploration and blood transfusions were postoperative factors that predisposed patients with median sternotomy to infection. Unlike their associated morbidity and mortality, predictors of deep and superficial sternal infections are similar.
منابع مشابه
Wound complications after median sternotomy: a single-centre study.
OBJECTIVES Sternal wound complications following median sternotomy remain a challenge in cardiac surgery. Changes in both patient profile and type of operations have been observed in recent years. Therefore, we analysed current wound healing complications after median sternotomy at our centre. METHODS All adult patients undergoing a median sternotomy between January 2009 and April 2011 were i...
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Background and purpose: Sternal Wound Infection (SWI) is a serious complication of median sternotomy that increases the rate of mortality. We report our experience of managing SWI in a regional cardiothoracic unit in Mazandaran province, Iran. Materials and methods: We prospectively studied 4725 patients who underwent isolated coronary artery bypass grafting between March 2012 and March 2015...
متن کاملRapid serodiagnosis of Staphylococcus aureus surgical site infection following median sternotomy.
OBJECTIVES To determine the sensitivity and specificity of a novel ELISA for the serodiagnosis of surgical site infection (SSI) due to staphylococci following median sternotomy. METHODS Twelve patients with a superficial sternal SSI and 19 with a deep sternal SSI due to Staphylococcus aureus were compared with 37 control patients who also underwent median sternotomy for cardiac surgery but ex...
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BACKGROUND We hypothesize that composite in-hospital surgical complications are lower in obese patients who undergo minimally invasive valve surgery for aortic and (or) mitral valve disease, when compared with the standard median sternotomy approach. METHODS We retrospectively reviewed 2,288 heart operations done at our institution between January 3, 2005 and January 10, 2010, and identified ...
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ورودعنوان ژورنال:
- Chest
دوره 110 5 شماره
صفحات -
تاریخ انتشار 1996