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The Annals of Thoracic Surgery, Vol 44, 173-179, Copyright © 1987 by The Society of Thoracic Surgeons
G Ottino, R De Paulis, S Pansini, G Rocca, MV Tallone, C Comoglio, P Costa, F Orzan and M Morea
From January, 1979, to December, 1984, at the Cardiac Surgery Department of
the University of Torino Medical School, major sternal wound infections
developed in 48 (1.86%) of 2,579 consecutive patients. These patients
underwent open-heart procedures through a midline sternotomy and survived
long enough for infection to appear. Possible risk factors were evaluated
by means of a multivariate analysis. For the group of patients, we
considered age, sex, hospital environment (different locations of our
surgical facilities over the years), interval between hospital admission
and operation, antibiotic prophylaxis, type of surgical procedure, elective
or emergency surgical procedure, reoperation, duration of surgical
procedures, duration of cardiopulmonary bypass, amount of blood transfused,
postoperative blood loss, chest reexploration, rewiring of a sterile
sternal dehiscence, duration of mechanical ventilation, and days of
treatment in the intensive care unit. Univariate analysis indicated that
age, sex, type and mode of surgical procedure, antibiotic prophylaxis, and
duration of mechanical ventilation were not significantly associated with
wound infection. For all other predisposing factors, a p value of less than
.05 was demonstrated. These variables were entered in a multiple stepwise
logistic regression. Six emerged as significant: hospital environment (p =
.0001), interval between admission and surgery (p = .041), reoperation (p
less than .0001), blood transfusions (p = .031), early chest reexploration
(p less than .0001), and sternal rewiring (p less than .0001).
Contamination of patients may occur before, during, and after operation,
and any kind of reintervention may predispose to wound infection.
ARTICLES
Major sternal wound infection after open-heart surgery: a multivariate analysis of risk factors in 2,579 consecutive operative procedures
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S. Hart and J. Roe Leucocyte depleting filters and cardiothoracic surgery Perfusion, November 1, 1993; 8(6): 477 - 482. [Abstract] [PDF]
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