title: Analysis of risk factors for sternal surgical site infection: emphasizing the appropriate ventilation of the operating theaters.
abstract: 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.
authors.affiliation: Department of Infectious Disease and Clinical Microbiology, Siyami Ersek Thoracic and Cardiovascular Surgery Hospital, Uskudar, Turkey. serapsim@superonline.com
authors.forename: Serap
authors.initials: S
authors.lastname: Simsek Yavuz
authors.forename: Yesim
authors.initials: Y
authors.lastname: Bicer
authors.forename: Nihan
authors.initials: N
authors.lastname: Yapici
authors.forename: Sibel
authors.initials: S
authors.lastname: Kalaca
authors.forename: Osman Ozcan
authors.initials: OO
authors.lastname: Aydin
authors.forename: Gercek
authors.initials: G
authors.lastname: Camur
authors.forename: Funda
authors.initials: F
authors.lastname: Kocak
authors.forename: Zuhal
authors.initials: Z
authors.lastname: Aykac
mesh_terms: 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*