Association between post-sternotomy tracheostomy and deep sternal wound infection: a retrospective analysis

Abstract

of the tracheostomy group. Seven of these 23 patients had DSWI after insertion of tracheostomy. DSWI was significantly higher in tracheostomy versus no-tracheostomy patients (10.2% vs. 0.48%; P<0.001). DSWI was also associated with higher mortality rates compared to non-DSWI patients (11.4% vs. 2.3%; P<0.001).Conclusions: The present study demonstrated that tracheostomy was an independent risk factor for post-sternotomy DSWI, and that DSWI was a predictor of mortality. For tracheostomy patients, coronary artery bypass grafting (CABG) procedures and longer durations of tracheostomy were strong predictors of DSWI. Across all sternotomy patients, tracheostomy, diabetes, urgency status and blood transfusions were significant risk factors for DSWI. As such, the decision for tracheostomy post-sternotomy should be carefully considered on a case by case basis.

Mediastinitis in the intensive care unit patient: a narrative review

“…Procedurerelated risk factors include the use of a ventricular assist device, transplant surgery [5,6], the use of bilateral internal mammary artery grafts, prolonged length of surgery, the use of aortic cross clamping, re-do surgery and finally on-pump perfusion [2,8]. Tracheostomy is also considered as a risk factor for DSWI, with early percutaneous tracheostomy being at higher risk [10,11].…”

Impact of preoperative nasopharyngeal cultures on surgical site infection after open heart surgery

“…Previous studies also demonstrated that tracheostomy was an independent risk factor for poststernotomy SSI. 23 , 24 We included less invasive use of the Portex Mini-Trach in addition to tracheostomy as a means of facilitated respiratory management following surgery. The spread of bacteria from the tracheostomy site to the sterile unhealed sternotomy has not been well addressed.…”

Hematogenous dissemination mediastinitis: case report

“…The incidence of AM associated with sternotomy is reported to be between 0.5% and 2.2% of cardiac surgeries, with mortality up to 14% 10 . Risk factors for sternal infection following cardiac surgery have been identified, such as advanced age, obesity, renal impairment, diabetes, hyperglycemia in non-diabetics 3 , heart failure, chronic obstructive pulmonary disease, smoking, ventricular assist devices, female gender 11 , nasal colonization by S. aureus 5 , and early percutaneous tracheostomy 12 .…”