The reported incidence of deep sternal wound infection (DSWI) after cardiac surgery is 0.4-5% with Staphylococcus aureus being the most common pathogen isolated from infected wound sternotomies and bacteraemic blood cultures. This infection is associated with a higher morbidity and mortality than other known aetiologies. Little is reported about the optimal antibiotic management. The aim of the...

OBJECTIVES Sternal wound dehiscence (SWD) after cardiac surgery is a rare but serious condition associated with considerable costs and morbidity. We sought to evaluate the results of the introduction of vacuum-assisted closure (VAC) therapy in the management of sternal wound dehiscence, compared with those of previous conventional treatments. METHODS We retrospectively collected 7148 patients...

BACKGROUND Median sternotomy infection and bony nonunion are two commonly described complications which occur in 0.4-5.1% of cardiac procedures. Although relatively infrequent, these complications can lead to significant morbidity and mortality. The aim of this retrospective study is to evaluate the initial experience of a transverse plate fixation system following wound complications associate...

BACKGROUND The aim of this prospective study is to evaluate the role in the onset of surgical site infections of bilateral internal thoracic arteries harvesting in patients with decompensated preoperative glycemia. METHODS 81 consecutive patients with uncontrolled diabetes mellitus underwent elective CABG harvesting single or double internal thoracic arteries. Single left ITA was harvested in...

(Oxford, UK): If what you have shown us is correct, because this is one of the longest propensity-matched follow-ups that exists in the literature, then again, as Professor Buxton showed us, this is potentially very important. But this is also the first time I have seen a paper on bilateral internal mammary arteries which showed no difference; there was absolutely no difference in deep sternal ...

BACKGROUND Obesity is frequently cited as a risk factor for adverse outcomes of major surgery. The results of prior studies of the relationship between obesity and risk of adverse outcomes of coronary artery bypass grafting (CABG) have been contradictory because of insufficient power to assess relatively infrequent outcomes or data to adjust for confounding factors. METHODS AND RESULTS Data o...

BackgroundThe purpose of this study was to evaluate postoperative outcomes with the use bilateral internal mammary artery (BIMA) conduits in obese patients.MethodsBetween January 2003 and December 2018, 8109 patients underwent isolated coronary bypass grafting, including 7218 (89%) treated single (SIMA) 891 (11%) BIMA grafts. Patients were divided into 3 groups according preoperative body mass ...

The cases of 4 children who developed postthoracotomy sternal wound infection caused by anaerobic bacteria are presented. The predominate anaerobes were Peptostreptococcus species and pigmented Prevotella species. Polymicrobial infection was present in all cases, and aerobic bacteria also were recovered in 2 instances. All patients responded to surgical debridement and antimicrobials effective ...

whether they are female (score = 2), diabetic (score = 1), Hb 1Ac > 7.5% (score = 3), BMI ≥ 35 (score = 2), ejection fraction ≤ 45% (score = 1), and emergency surgery (score = 2). Identification of patients who are at high or medium risk for SWI then triggers a cascade of events and interventions aimed at eliminating the occurrence of SWI. One of the key areas we have aggressively focused on is...