A prospective study of prevalence of 60-days postoperative wound infections after cardiac surgery. An updated risk factor analysis.
OBJECTIVE
Postoperative wound infections generally cause considerable extra morbidity, mortality and costs. The prevalence of total wound infections after cardiac surgery, including both sternal wound and donor site infections, ranges from 1.3 to 12.8%. The present study was conducted to identify the incidence of wound infections following cardiac surgery, to identify the risk factors and evaluate the efficacy of present modes of management.


METHODS
From September 2004 to May 2005, 493 consecutive patients undergoing cardiac surgery were included in the study and were followed for the prevalence of surgical site infection (SSI) up to 60 days postoperatively. The wound infections were defined according to the Centers for Disease Control and Prevention (CDC) and U.S. National Nosocomial Infections Surveillance (NNIS) system criteria.


RESULTS
The total incidence of SSI was 3.9%. Sternal wound infection (SWI) occurred in 17 patients (3.4%). Superficial wound infection was diagnosed in 10 patients (2%) and deep wound infection in 7 patients (1.4%). Donor site infection (DSI) occurred in 2 patients (0.4%). Early reoperation for bleeding, postoperative dialysis and the use of one internal mammary artery were independently associated with an increased risk of SWI.


CONCLUSIONS
Preventing SSI in the operating room is the primary goal of the surgical team. Attention should be paid to antibiotic prophylaxis and Methicillin-resistant Staphylococcus aureus (MRSA) nasal carriage treatment. The identification of risk factors will help to further reduce the incidence of wound infection.
Centofanti
P
P
Department of Cardiac Surgery University of Turin, Turin, Italy. paolocentofanti@tiscali.it
Savia
F
F
La Torre
M
M
Ceresa
F
F
Sansone
F
F
Veglio
V
V
Fossati
L
L
Guglielmi
E
E
Rinaldi
M
M
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D019072:Antibiotic Prophylaxis; D006348:Cardiac Surgical Procedures / Q000009:adverse effects*; D003922:Diabetes Mellitus, Type 1 / Q000150:complications*; D003956:Dialysis / Q000009:adverse effects*; D005260:Female; D005500:Follow-Up Studies; D006489:Hemostatic Techniques / Q000009:adverse effects*; D006801:Humans; D015994:Incidence; D007387:Internal Mammary-Coronary Artery Anastomosis / Q000009:adverse effects; D007902:Length of Stay; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000150:complications*; D015995:Prevalence; D011446:Prospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D013530:Surgical Wound Infection / Q000453:epidemiology / Q000209:etiology* / Q000517:prevention & control; D013997:Time Factors; D016896:Treatment Outcome