Analysis of risk factors for sternal surgical site infection: emphasizing the appropriate ventilation of the operating theaters.
OBJECTIVE
To determine the incidence of and identify risk factors for sternal surgical site infection (SSI).


METHODS
Prospective cohort study. Data on potential risk factors, including the type of operating theater and infection data, were collected prospectively and analyzed by multivariate analysis.


METHODS
Siyami Ersek Thoracic and Cardiovascular Surgery Hospital, a 700-bed teaching hospital and the largest center for cardiac surgery in Turkey. The cardiothoracic unit performs approximately 3,000 cardiac operations per year.


METHODS
All adult patients who underwent cardiac surgery with sternotomy between January 14, 2002, and July 1, 2002, and who survived at least 4 days after surgery were included in the study.


RESULTS
Potential risk factor data were complete for 991 patients. There was sternal SSI in 41 patients (4.1%). Female sex, diabetes mellitus, operation performed in the older operating theaters, and duration of procedure exceeding 5 hours were identified as independent risk factors for sternal SSI.


CONCLUSIONS
Female and diabetic patients are at higher risk for sternal SSI and should be followed up carefully after cardiac surgery to prevent the development of sternal SSI. Reducing the duration of surgery could reduce the rate of postoperative sternal SSI. The operating theater environment may have an important role in the pathogenesis of sternal SSI, and appropriate ventilation of the operating theaters would be critical in the prevention of sternal SSI.
Simsek Yavuz
Serap
S
Department of Infectious Disease and Clinical Microbiology, Siyami Ersek Thoracic and Cardiovascular Surgery Hospital, Uskudar, Turkey. serapsim@superonline.com
Bicer
Yesim
Y
Yapici
Nihan
N
Kalaca
Sibel
S
Aydin
Osman Ozcan
OO
Camur
Gercek
G
Kocak
Funda
F
Aykac
Zuhal
Z
D006348:Cardiac Surgical Procedures / Q000706:statistics & numerical data; D001026:Coronary Artery Bypass; D048909:Diabetes Complications; D005260:Female; D017052:Hospital Mortality; D006801:Humans; D016015:Logistic Models; D008297:Male; D009873:Operating Rooms / Q000592:standards*; D011182:Postoperative Care; D012307:Risk Factors; D013530:Surgical Wound Infection / Q000209:etiology* / Q000517:prevention & control; D014421:Turkey / Q000453:epidemiology; D014691:Ventilation / Q000592:standards*