title: Incidence of sternocutaneous fistulas following open heart surgery in a nationwide cohort.
abstract: We studied the incidence and characteristics of surgically treated sternocutaneous fistulas in a nationwide cohort of patients undergoing open heart surgery in Iceland. Between 2000 and 2010, sternocutaneous fistulas were treated surgically in 6 out of 2446 patients undergoing open heart surgery (incidence 0.25%, 95% confidence interval 0.11-0.53%). All patients were male, with a mean age of 71 ± 9 y. In addition to antibiotic treatment, debridement of the wound was performed in all cases. Staphylococcus aureus and/or coagulase-negative staphylococci were identified as pathogens in 5 cases and Candida albicans in 1. Chronic infections developed in 3 patients who were treated repeatedly, 1 of them unsuccessfully. In-hospital stay ranged from 0 to 50 days (mean 19 days). Sternocutaneous fistulas are rare, but since they may have a devastating course, increased awareness of this infectious complication of open heart surgery is important.
authors.affiliation: Department of Cardiothoracic Surgery, Landspitali University Hospital, Reykjavik, Iceland.
authors.forename: Steinn
authors.initials: S
authors.lastname: Steingrímsson
authors.forename: Johan
authors.initials: J
authors.lastname: Sjögren
authors.forename: Tomas
authors.initials: T
authors.lastname: Gudbjartsson
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D006348:Cardiac Surgical Procedures / Q000009:adverse effects*; D015331:Cohort Studies; D017577:Cutaneous Fistula / Q000209:etiology* / Q000382:microbiology; D006801:Humans; D015994:Incidence; D008297:Male; D011446:Prospective Studies; D013203:Staphylococcal Infections / Q000209:etiology / Q000382:microbiology; D013211:Staphylococcus aureus / Q000302:isolation & purification; D013249:Sternum / Q000382:microbiology / Q000601:surgery*; D013530:Surgical Wound Infection / Q000209:etiology* / Q000382:microbiology