title: Risk analysis and outcome of mediastinal wound and deep mediastinal wound infections with specific emphasis to omental transposition.
abstract: BACKGROUND
  To report our experience, with Deep mediastinal wound infections (DMWI). Emphasis was given to the management of deep infections with omental flaps
  
  
  METHODS
  From February 2000 to October 2007, out of 3896 cardiac surgery patients (prospective data collection) 120 pts (3.02%) developed sternal wound infections. There were 104 males & 16 females; (73.7%) CABG, (13.5%) Valves & (9.32%) CABG and Valve.
  
  
  RESULTS
  Superficial sternal wound infection detected in 68 patients (1.75%) and fifty-two patients (1.34%) developed DMWI. The incremental risk factors for development of DMWI were: Diabetes (OR = 3.62, CI = 1.2-10.98), Pre Op Creatinine > 200 μmol/l (OR = 3.33, CI = 1.14-9.7) and Prolong ventilation (OR = 4.16, CI = 1.73-9.98). Overall mortality for the DMWI was 9.3% and the specific mortality of the omental flap group was 8.3%. 19% of the "DMWI group", developed complications: hematoma 6%, partial flap loss 3.0%, wound dehiscence 5.3%. Mean Hospital Stay: 59 ± 21.5 days.
  
  
  CONCLUSIONS
  Post cardiac surgery sternal wound complications remain challenging. The role of multidisciplinary approach is fundamental, as is the importance of an aggressive early wound exploration especially for deep sternal infections.
authors.affiliation: Cardiothoracic Department, Royal Victoria Hospital, Grosvenor Rd, Belfast, BT12 6BA, UK. hparissis@yahoo.co.uk
authors.forename: Haralabos
authors.initials: H
authors.lastname: Parissis
authors.forename: Bassel
authors.initials: B
authors.lastname: Al-Alao
authors.forename: Alan
authors.initials: A
authors.lastname: Soo
authors.forename: David
authors.initials: D
authors.lastname: Orr
authors.forename: Vincent
authors.initials: V
authors.lastname: Young
mesh_terms: D000368:Aged; D016009:Chi-Square Distribution; D003646:Debridement; D005260:Female; D017052:Hospital Mortality; D006801:Humans; D007494:Ireland / Q000453:epidemiology; D008297:Male; D008480:Mediastinitis / Q000453:epidemiology* / Q000382:microbiology / Q000401:mortality / Q000601:surgery*; D008875:Middle Aged; D054843:Negative-Pressure Wound Therapy; D009852:Omentum / Q000637:transplantation*; D018570:Risk Assessment; D012307:Risk Factors; D013524:Surgical Flaps; D013530:Surgical Wound Infection / Q000453:epidemiology* / Q000382:microbiology / Q000401:mortality / Q000601:surgery*; D013536:Suture Techniques; D016896:Treatment Outcome