title: Risk factors and management approach for deep sternal wound infection after cardiac surgery at a tertiary medical centre.
abstract: BACKGROUND
  Deep sternal wound infection (DSWI) is a rare but severe complication following cardiac surgery. Our study investigated the risk factors and treatment options for patients who developed DSWI at our institution between May 1988 and April 2008.
  
  
  METHODS
  Data was collected prospectively in a database and information on demographics reviewed retrospectively on 5649 patients who underwent cardiac surgery during this period.
  
  
  RESULTS
  The incidence of DSWI was 34/5649 (0.6%). These patients were older (mean age 66.1 vs. 64.5), more likely to die (in hospital mortality 11.8% vs. non DSWI group 1.8%) and had longer hospital stays (DSWI group mean stay 25 days vs. non DSWI group 9 days). Using Fisher's exact test the risk predictors for DSWI determined at our institution included diabetes managed with oral medications (p=0.021), previous cardiac surgery (p=0.038), BMI≥30 (p=0.041), LVEF≤30 (p=0.010), IABP usage (p=0.028) and homologous blood usage (p<0.001). Most commonly bilateral pectoralis major muscle flap (BPMMF) was used for treatment of DSWI (11/30, 36.7%).
  
  
  CONCLUSIONS
  Ultimately our data was comparable to published data in the literature on known risk predictors.
authors: Department of Cardiothoracic Surgery, Princess Alexandra Hospital, Woolloongabba, Brisbane, QLD 4102, Australia. peter floros@hotmail.com
authors: Peter
authors: P
authors: Floros
authors: Raja
authors: R
authors: Sawhney
authors: Marosh
authors: M
authors: Vrtik
authors: Anton
authors: A
authors: Hinton-Bayre
authors: Paul
authors: P
authors: Weimers
authors: Shireen
authors: S
authors: Senewiratne
authors: Julie
authors: J
authors: Mundy
authors: Pallav
authors: P
authors: Shah
mesh_terms: D006348:Cardiac Surgical Procedures / Q000009:adverse effects*; D016208:Databases, Factual; D005260:Female; D006801:Humans; D015994:Incidence; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012189:Retrospective Studies; D012307:Risk Factors; D013249:Sternum / Q000293:injuries*; D013530:Surgical Wound Infection / Q000453:epidemiology* / Q000209:etiology / Q000628:therapy*; D013997:Time Factors