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Analysis of Risk Factors in Poststernotomy Sternal Wound Infection and Mediastinitis after Open-heart Surgery  

Chang, Won-Ho (Dept. of Thoracic and Cardiovascular Surgery, Soonchunhyang University Hospital)
Park, Han-Gyu (Dept. of Thoracic and Cardiovascular Surgery, Soonchunhyang University Hospital)
Kim, Hyun-Jo (Dept. of Thoracic and Cardiovascular Surgery, Soonchunhyang University Hospital)
Youm, Wook (Dept. of Thoracic and Cardiovascular Surgery, Soonchunhyang University Hospital)
Publication Information
Journal of Chest Surgery / v.36, no.8, 2003 , pp. 583-589 More about this Journal
Abstract
With the purpose of identifying significant risk factors in poststernotomy sternal wound infection and mediastinitis, we underwent a retrospective analysis of the whole patients operated on at the our department of cardiovascular surgery for the two years. Material and Method: From March 200f to March 2003 at the depart-ment of cardiovascular surgery, medical school of Soonchunhyang University, major sternal wound infections had been developed in 12 (9.76%) of 123 consecutive patients. These patients underwent open-heart procedure through a midline sternotomy and survived long enough for infection to appear. For this group of patients, we evaluated possible risk factors such as age, sex, diabetes mellitus, chronic obstructive pulmonary disease, obesity, interval between hospital admission and operation, type of surgical procedure, elective or emergency surgical procedure, reoperation, duration of surgical procedures, duration of cardiopulmonary bypass, amount of blood transfused, post-operative blood loss, chest reexploration, rewiring of a sterile sternal dehiscence, duration of mechanical ventilation, and days of stay in the intensive care unit and analyzed these factors. Result: Analysis represented that age, sex, diabetes mellitus, type and mode of surgical procedure, reoperation, duration of operation, duration of cardio-pulmonary bypass, and interval between hospital admission and operation were not significantly associated with wound infection. For all other predisposing factors, p-values of less than .05 were demonstrated. Eight emerged as significant: early chest reexploration (p=0.001), sternal rewiring (p< 0.0001), chronic obstructive pulmonary disease (p<0.0001), blood transfusions (p<0.05), postoperative bleeding (p=0.008), days of stay in the intensive care unit (p< 0.0001), duration of mechanical ventilation (p=0.001), and obesity (p=.003). Conclusion: Contamination of pa-tients may occur before, during, and after the operation, and any kind of reintervention may predispose the patient to wound infection.
Keywords
Sternotomy; Wound infection; Mediastinitis;
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1 Risk factors for wevere bacterial infections after valve replacement and aortocoronary bypass operations: analysis of 246 cases by logistic regression /
[ Miholic J; Hudec M;Domanig E(al. et.) ] / Ann Thorac Surg   DOI   ScienceOn
2 Mdiastinites aigues suppurees anec hemocultures positives dans la sute de la chirurgle cardiovasculaire /
[ Bruniaux J; gilbert G;Witchitz J(al.et.) ] / Ann Chir Thorac Cardiovasc
3 Mediastinitis following open-heart surgery:review of two years' experience /
[ Engelman,R.M.;Williams,C.D.;Gouge,T.H.(et al.) ] / Arch Surg.
4 Risk factors influencing the outcome after surgical treatment of complicated deep sternal wound complications /
[ A.A.Peivandi;W.Kasper Konig;E.Quinkenstein,A(et al.) ] / Cardio vasc Surg.   DOI   ScienceOn
5 Treatment of mediastinitis in children after cardiac surgery:a study of 20 cases /
[ Barois,A.;Grosbuis,S.;Simon,N.(et al.) ] / Intensive Care Med.   DOI
6 A survey of seventy-seven major infectious complications of median sternotomy:a review of 7,949 consecutive operative procedures /
[ Grossi,E.A.;Culliford,A.T.;Krieger,K.,H.(et al.) ] / J. Thorac Cardiovasc Surg.
7 Median sternotomy dehiscence /
[ Stoney,W.S.;Alford,W.C.Jr.;Burrus,G.R.(et al.) ] / Ann Thorac Surg.   DOI   ScienceOn
8 Sources of gram-negative infection after open-heart surgery /
[ Rosendorf,L.L.;Daicoff,G.;Baer,H. ] / J. Thorac Cardiovasc Surg.
9 Pseudomonas sternotomy wound infection and sternal osteomylitis /
[ Stiver,H.G.;Clark,J.;Kennedy,J.;Cohen,M. ] / JAMA   DOI   ScienceOn
10 High-pressure suction drainage via a polyurethave foam in the management of poststernotomy mediastini신 /
[ ,;Martin H(al.et.) ] / Ann Thorac Surg   DOI   ScienceOn
11 Sternal wound complication:management and results /
[ Serry,C.;Bleck,P.C.;Javid,H.(et al.) ] / J Thorac Cardiovasc Surg
12 Sternal and costochondral infections following open-heart surgery: a review of 2594 cases /
[ Culiford AT; Cunningham JM Jr;zeff RH(al.et.) ] / J Thorac Cardiovasc Surg
13 Major complications of median sternotomy /
[ Grmoljez PF; Barner HB; Willman VL; Kaiser GC ] / Am J Surg   DOI   ScienceOn
14 Complications of median sternotomy in cardiovascular surgery /
[ Hechrlein,F.W.;Herrmann,H.;Kraus,J. ] / J Cardiovasc Surg(Torino)
15 A prospective study of sternal wound complications /
[ Breyer,R.H.;Mills,S.A.;Hudspeth,A.S.(et al.) ] / Ann Thorac Surg.   DOI   ScienceOn
16 Wound complications after midian sternotomy: a study of 61 patients from a consecutive series of 9279 /
[ Ott DA; Cooley DA;Solis RT(al.et.) ] / Cardiovasc Dis (Bull Tex Heart Inst)
17 Mediastinal infection alter cardiac surgery (collective review) /
[ Sarr MG; Gott VL; Townsend TR ] / Ann Thorac Surg   DOI   ScienceOn
18 complications associated with median sternotomy /
[ Sanfelippo PM; Danielson GK ] / J Thorac Cardiovascular Surg
19 Sternal osteomyelitis and mediastinitis after open-heart operation: patohgenesis and prevention /
[ Weinsein RA; Jones EL;Scharzmann SW(al.et.) ] / Ann Thorac Surg   DOI   ScienceOn
20 Comparoson between antibiotic irrigation and mobilization of pectoral muscle floaps in treatment of deep sternal infections /
[ Scully HE; Leclerc Y;Martin RK(al.et.) ] / J Thorac Cardivasc Surg