title: [Surgical site infections in children undergoing cardiac surgery with delayed sternal closure: Case-control study].
abstract: BACKGROUND
  Surgical site infections (SSI) are an important cause of morbidity in pediatric cardiac surgery. Risk factors in patients requiring delayed sternal closure (DSC) are unknown.
  
  
  OBJECTIVE
  To report the rate of SSI in children undergoing cardiac surgery with DSC and determine the risk factors.
  
  
  METHODS
  A retrospective case-control study, in patients younger than 15 years old undergoing cardiac surgery with DSC in our center between 2009 and 2010. SSI was diagnosed according to the criteria of the nosocomial infections committee of our institution, based on international recommendations. Univariate and multivariate analysis of variables was performed. A p < 0.05 was considered significant.
  
  
  RESULTS
  58 patients were included; the average age was 9.5 days. The most frequent diagnosis were transposition of the great arteries (36%) and hypoplastic left heart syndrome (27%). 13 patients had SSI (22%); 11 incisional and 2 mediastinitis. It was independently associated to SSI by-pass (BP) time longer than 200 min (OR adjusted = 9,53; IC 95% 1,37-66,35) and mechanical ventilation (MV) more than 5 days (OR adjusted = 8,98; IC 95% 1,16-69,40).
  
  
  CONCLUSIONS
  The duration of BP and MV are risk factors of SSI in children undergoing cardiac surgery with DSC.
authors.affiliation: División de Pediatría, Facultad de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile, claveria@med.puc.cl.
authors.forename: Javiera
authors.initials: J
authors.lastname: Retamal
authors.affiliation: División de Enfermedades Cardiovasculares, Facultad de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile.
authors.forename: Pedro
authors.initials: P
authors.lastname: Becker
authors.affiliation: División de Enfermedades Cardiovasculares, Facultad de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile.
authors.forename: Rodrigo
authors.initials: R
authors.lastname: González
authors.affiliation: División de Pediatría, Facultad de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile, claveria@med.puc.cl.
authors.forename: Marcela
authors.initials: M
authors.lastname: Ferrés
authors.affiliation: Departamento de Salud Pública, Facultad de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile.
authors.forename: Jaime
authors.initials: J
authors.lastname: Cerda
authors.affiliation: Comité de Prevención y Control IAAS, Hospital Clínico, Red de Salud UC CHRISTUS, Santiago, Chile.
authors.forename: María I
authors.initials: MI
authors.lastname: Riquelme
authors.affiliation: División de Pediatría, Facultad de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile, claveria@med.puc.cl.
authors.forename: Regina
authors.initials: R
authors.lastname: Pérez
authors.affiliation: División de Pediatría, Facultad de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile, claveria@med.puc.cl.
authors.forename: Cristián
authors.initials: C
authors.lastname: Clavería
mesh_terms: D006348:Cardiac Surgical Procedures / Q000009:adverse effects* / Q000379:methods; D016022:Case-Control Studies; D002648:Child; D002675:Child, Preschool; D005260:Female; D006330:Heart Defects, Congenital / Q000601:surgery*; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D012189:Retrospective Studies; D012307:Risk Factors; D056346:Sternotomy / Q000009:adverse effects*; D013530:Surgical Wound Infection / Q000453:epidemiology / Q000517:prevention & control