Risk Factors for Sternal Wound Infection After Open Heart Operations Vary According to Type of Operation

Meszaros, Katharina; Fuehrer, Urs; Grogg, Sina; Sodeck, Gottfried; Czerny, Martin; Marschall, Jonas; Carrel, Thierry

doi:10.1016/j.athoracsur.2015.09.010

Cited by 80 publications

(87 citation statements)

References 29 publications

(30 reference statements)

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“…They are associated with significant morbidity and mortality, prolonged hospital stay, and exorbitant healthcare costs . The reported total incidence of sternal wound infections after cardiac surgery ranges from 1 to 8% accounting for an in‐hospital mortality of up to 25% …”

Section: Introductionmentioning

confidence: 99%

Cefuroxime plasma and tissue concentrations in patients undergoing elective cardiac surgery: Continuous vs bolus application. A pilot study

Skhirtladze-Dworschak

Hutschala

Reining

et al. 2019

Brit J Clinical Pharma

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Aims Surgical site infections contribute to morbidity and mortality after surgery. The authors hypothesized that higher antibiotic tissue concentrations can be reached for a prolonged time span by continuous administration of prophylactic cefuroxime compared to bolus administration. Methods Twelve patients undergoing elective cardiac surgery were investigated. Group A received 1.5 g cefuroxime as bolus infusions before surgery, and 12 and 24 hours thereafter. In group B, a continuous infusion of 3.0 g cefuroxime was started after a bolus of 1.5 g. Cefuroxim levels were determined in blood and tissue (microdialysis). T‐test, Wilcoxon signed rank test and χ2 test were used for statistical analysis. Results The area under the curve (AUC) of plasma cefuroxime concentrations was greater in group B (399 [333–518]) as compared to group A (257 [177–297] h mg L−1, [median and interquartile range], P = .026). Furthermore, a significantly longer percentage of time > minimal inhibitory concentrations of 2 mg L−1 (100% vs 50%), 4 mg L−1 (100% vs 42%), 8 mg L−1 (100% vs 17%) and 16 mg L−1 (83% vs 8%) was found for free plasma cefuroxime in group B. In group B, area under the curve in subcutaneous tissue (78 [61–113] h mg L−1) and median peak concentration (33 [26–38] mg L−1) were markedly higher compared to group A (P = 0.041 and P = .026, respectively). Conclusions Higher cefuroxime concentrations were measured in plasma and subcutaneously over a prolonged period of time when cefuroxime was administered continuously. The clinical implication of this finding still has to be elucidated.

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Section: Introductionmentioning

confidence: 99%

Cefuroxime plasma and tissue concentrations in patients undergoing elective cardiac surgery: Continuous vs bolus application. A pilot study

Skhirtladze-Dworschak

Hutschala

Reining

et al. 2019

Brit J Clinical Pharma

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“…The two patients (4%) whom show chest wall infection one (2%) revealed chronic osteomyelitis and one (2%) demonstrated deep sternal wound infection with retrosternal collection. In 2016 Meszaros et al, [17] stated that incidence of deep sternal wound infection varies from (0.4 to 4%).…”

Section: Discussionmentioning

confidence: 99%

Diagnostic Value of 64-Slice Multi Detector Computed Tomographic Angiography in Assessment of Complicated Coronary Artery Bypass Graft

Mohamed¹,

Helmy

Sakr³

et al. 2018

The Medical Journal of Cairo University

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Background: Coronary Artery Bypass Grafting (CABG) is to replace occluded or stenosed coronary arteries with patent venous or arterial conduits. Long-term sequelae after CABG include native coronary artery disease progression and de novo arthrosclerosis in grafts, resulting in recurrent ischemic symptoms and mortality. Aim of Study:This study was undertaken to form the basis of review on the role of 64 Multi-Detector Computed Tomography (MDCT) in detecting possible complications in post coronary artery graft (CABG) patients. Material and Methods:During the period from November 2015 to August 2017, a prospective evaluation of 50 patients with suspected post-CABG complications underwent MDCT coronary angiography in radiology department of International Medical Center in Egypt. Informed consent was obtained from all patients and the study had institutional review board approval. Descriptive statistics were used to analyze the data.Results: There were 40 males and 10 females, their mean age ± (SD) of 59±3.9 years. A total of 129 grafts were available for evaluation. From the total 129 graft 25 grafts were occluded as 24 of them showing the occlusion at the proximal anastomosis and the remaining one at the distal anastomosis. 8 grafts showed significant stenosis. Two showing ulceration at anastomotic site and 6 showing kinking course while one was showing competitive flow distally and one showing retrograde felling. Four grafts show stent placement. From the total evaluated 50 patients four patients were underwent redu operation. One patient had partial thrombosis in left subclavian artery encroaching upon LIMA origin. Three patients were suffering from fever one had pneumonia and the other two had chest wall infection with retrosternal extension and associated mediastinal involvement. Four patients show sternal dehiscence. One patient showed localized pericardial hematoma. Sex patients showed ascending aortic aneurysm and two showed main pulmonary artery aneurysm. All these complications occurred from 6 menthes to 13 years post CABG surgery. Conclusion:MDCT is an easy non-invasive technique which showed to be effective in diagnosis of post-operative CABG related and non-related complications and is very informitive in difficult clinical situations.

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“…Sok rizikótényező ismert, amely hozzájárulhat a szívműtét utáni poststernotomiás sebfertőzés kialakulásához [9,10]. Vizsgálatunkban arra a megállapításra jutottunk, hogy a perifériás érbetegség jelentős mértékben járul hozzá a sebészi rekonstrukció sikertelenségéhez.…”

Section: Következtetésunclassified

A poststernotomiás sebfertőzések kezelési sikertelenségének prediktív faktorai

Rashed¹,

Gombocz²,

Frenyó³

et al. 2018

Orvosi Hetilap

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Risk Factors for Sternal Wound Infection After Open Heart Operations Vary According to Type of Operation

Cited by 80 publications

References 29 publications

Cefuroxime plasma and tissue concentrations in patients undergoing elective cardiac surgery: Continuous vs bolus application. A pilot study

Cefuroxime plasma and tissue concentrations in patients undergoing elective cardiac surgery: Continuous vs bolus application. A pilot study

Diagnostic Value of 64-Slice Multi Detector Computed Tomographic Angiography in Assessment of Complicated Coronary Artery Bypass Graft

A poststernotomiás sebfertőzések kezelési sikertelenségének prediktív faktorai

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