Management plan for deep sternal wound infection targeting to survival free of recurrence: A prospective evaluation study

Kasb, Ibrahim; Amr, Mohamed A.

doi:10.1016/j.jescts.2016.04.001

Cited by 3 publications

(6 citation statements)

References 17 publications

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“…364. This goes with Chan et al (13) in which the mean BMI was (28.8 ±4.3) and with Kasb and Amr (12) in which the mean BMI was 30.3 ± 4.1.…”

Section: Discussionsupporting

confidence: 79%

“…In the period of the study, we found that 1053 patients underwent open heart surgery in Mansoura University Hospitals, Cardiothoracic Department among them 31 patients had DSWI; the incidence was 2.9%. This goes with Gwely et al (1) as the incidence of deep sternotomy wound infection was 4.6%, Nešpor et al (11) the incidence was 2.28%, and in Kasb and Amr (12) it was 1.54%.…”

Section: Discussionsupporting

confidence: 67%

“…In our study the mean age was 58.23±7.898 years. This goes with Kasb and Amr (12) in which the mean age was 61.5± 8.2 years, while, Chan et al (13) age was higher (68.2 ±12.0 years) as he had lesser number of patients with valve replacement. The mean BMI was 32.18 ±5.…”

Section: Discussionmentioning

confidence: 58%

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Management of Deep Median Sternotomy Wound Infection after Open Heart Surgery

Gwely

Amer

ElDerie

et al. 2021

The Egyptian Journal of Hospital Medicine

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Background: Deep sternal wound infection (DSWI) is a rare but potentially devastating complication of median sternotomy performed in cardiac surgery. The incidence of DSWI is reported to be between 0.2% and 3%. Identifying high-risk patients and strategies to optimize risk factors plays an important role in reducing the incidence of DSWI. Objective: This retrospective prospective study was designed to evaluate the management of deep median sternotomy wound infection after open heart surgery as regard the risk factors, rate and the outcome of its surgical treatment in

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“…364. This goes with Chan et al (13) in which the mean BMI was (28.8 ±4.3) and with Kasb and Amr (12) in which the mean BMI was 30.3 ± 4.1.…”

Section: Discussionsupporting

confidence: 79%

Section: Discussionsupporting

confidence: 67%

See 1 more Smart Citation

Management of Deep Median Sternotomy Wound Infection after Open Heart Surgery

Gwely

Amer

ElDerie

et al. 2021

The Egyptian Journal of Hospital Medicine

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“…We concluded an incidence of DSWI of 5.6%. Other studies reported lower incidences (1.5% to 1.8%) [2] [11] [12]. The relatively high incidence in this study could be attributed to higher rates of uncontrolled hypertension, DM, COPD, and obesity among our patients.…”

Section: Discussioncontrasting

confidence: 47%

“…Deep sternal wound infection (DSWI), also called mediastinitis, is a serious complication after median sternotomy with an incidence of 1% to 5%. While superficial sternal wound infections (SSWI) involve the skin, subcutaneous tissue, and pectoralis fascia only and have much less mortality (0.5% to 9%), DSWI involves retrosternal space, prolongs the hospital stay by an average of 20 days, and is associated with a mortality of 10% to 47% which is double the mortality of those without mediastinitis [1] [2]. The incidence of DSWI is particularly high in the presence of diabetes mellitus (DM), smoking history, chronic obstructive pulmonary disease (COPD), osteoporosis and obesity [1] [2] [3] [4] Prolonged stay in the intensive care unit (ICU), use of assistive devices and reoperation boost the incidence as well.…”

Section: Introductionmentioning

confidence: 99%

Deep Sternal Wound Infections after Coronary Artery Bypass Grafting: Analysis of 29 Cases from Iraq

Alkhateeb¹,

Ah-Ghurabi²,

Alkaaby³

et al. 2022

WJCS

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Background: Deep sternal wound infection (DSWI), or mediastinitis, is a devastating complication of coronary artery bypass grafting (CABG). This prospective study aimed to assess our management of DSWI in view of the published literature. Methods: Over 2-years (ending in January 2016), 29 patients (20 males) developed DSWI amongst 520 patients who underwent standard CABG surgeries (5.6%). Pre-, intra-and postoperative variables were documented. Whenever possible, the infections were culture-verified. Besides antibiotics, patients received one or more of the following therapies: drainage, debridement, closed irrigation, sternal re-wiring, vacuum-assisted closure (VAC), and bone resection. Results: the male to female ratio was 2.2:1. Mean age was 58.1 ± 7.3 years. The mean body mass index (BMI) was 27.9 ± 3.4 kg/m 2 . There were 18, 16 and 11 patients with diabetes mellitus (DM), hypertension and chronic obstructive pulmonary disease (COPD) respectively. Cardiopulmonary bypass (CPB) was utilized in 26 (89.7%) patients with a mean time of 117.5 ± 23.3 minutes. Most surgeries (n = 21, 72.4%) lasted 5 -6 hrs. According to Pairolero classification, there were 3 (10.3%) Type I, 22 (75.9%) Type II and 4 (13.8%) Type III infections. Four (13.8%) cases were culture-verified. Twenty-three (79.3%) DSWIs were surgically managed. Sternal re-wiring was performed in 14 (48.3%) cases while VAC was added to other therapies in 2 (6.9%) patients. DSWIs completely resolved in 18 (62.0%) patients within 3 -24 weeks while two (6.9%) patients died within 30 days. Conclusion: We have identified six independent risk factors for DSWI (male gender, obesity, DM, hypertension, COPD and CPB), five of them are modifiable.

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