Sex-Associated Differences in Short-Term Outcomes in Patients with Deep Sternal Wound Infection after Open-Heart Surgery

Krasivskyi, Ihor; Ivanov, Borko; Eghbalzadeh, Kaveh; Fehlau, Frederike; Gerfer, Stephen; Großmann, Clara; Elderia, Ahmed; Sabashnikov, Anton; Rahmanian, Parwis B.; Mader, Navid; Djordjevic, Ilija; Wahlers, Thorsten

doi:10.3390/jcm11247510

Cited by 3 publications

(5 citation statements)

References 42 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Biancari et al found that the female sex is a predictor for the development of deep sternal wound infections [ 14 ]. Breyer et al and Itagaki et al also demonstrated a significantly higher occurrence of postoperative deep sternal wound infections in women and concluded that the female sex is an independent risk factor for the development of deep sternal wound infections, whereas Krasivskyi et al, in their study, did not see such a difference [ 30 , 31 , 32 ]. Gatti et al analyzed 2.872 patients after isolated CABG surgery and showed that the female sex was a strong predictor of DSWI [ 33 ].…”

Section: Discussionmentioning

confidence: 93%

See 1 more Smart Citation

The Impact of Gender and Age in Obese Patients on Sternal Instability and Deep-Sternal-Wound-Healing Disorders after Median Sternotomy

Braun

Schröter

Laux

et al. 2023

JCM

View full text Add to dashboard Cite

Objective: The aim of this study was to investigate the relationship between age and sex in regard to the development of deep sternal wound infections and sternal instability following median sternotomy. Methods: A propensity-score-matching analysis was conducted on 4505 patients who underwent cardiac surgery between 2009 and 2021, all of whom had a BMI of ≥30 kg/m2. A total of 1297 matched pairs were determined in the sex group, and 1449 matched pairs we determined in the age group. The distributions of sex, age, diabetes mellitus, delirium, unstable sterna, wire refixation, wire removal, superficial vacuum-assisted wound closure, deep vacuum-assisted wound closure, clamp time, bypass time, logistic EuroSCORE, and BMI were determined. Results: The 30-day in-hospital mortality was found to be similar in the older and younger groups (8.149% vs. 8.35%, p = 0.947), and diabetes mellitus was also equally distributed in both groups. However, postoperative delirium occurred significantly more often in the older group (29.81% vs. 17.46%, p < 0.001), and there was a significantly higher incidence in men compared with women (16.96% vs. 26.91%, p < 0.001). There were no differences found in the incidence of sternum instability, fractured sternum, superficial vacuum-assisted wound closure, and deep vacuum-assisted wound closure between the age and sex groups. Conclusions: In conclusion, this study found that sternal instability and deep-wound-healing problems occur with equal frequency in older and younger patients and in men and women following median sternotomy. However, the likelihood of postoperative delirium is significantly higher in older patients and in men. These findings suggest that a higher level of monitoring and care may be required for these high-risk patient groups to reduce the incidence of postoperative delirium and improve outcomes following median sternotomy.

show abstract

Section: Discussionmentioning

confidence: 93%

“…The interaction between CABG and one or both ITAs, along with female sex, were strongly associated with CDC-negative surgical site infection (SSI). Indeed, tension of the breast upon the skin wound may be an additional risk factor for delayed wound healing and wound leakage, leading to SSI [ 32 ].…”

Section: Discussionmentioning

confidence: 99%

The Impact of Gender and Age in Obese Patients on Sternal Instability and Deep-Sternal-Wound-Healing Disorders after Median Sternotomy

Braun

Schröter

Laux

et al. 2023

JCM

View full text Add to dashboard Cite

show abstract

“…We formed two groups to investigate potential sex-related differences in early clinical outcomes: men (n = 255) and women (n = 88). To account for the unequal cohort sizes, we performed a propensity score-based matching (PSM) analysis using the methods previously described [ 22 ]. The details of the analysis are provided in Figure 1 .…”

Section: Methodsmentioning

confidence: 99%

“…Standard anticoagulation protocols were used by all patients after the OPCAB procedure, which were similar in Cologne and Tuebingen. Our methods were previously described [ 22 ].…”

Section: Methodsmentioning

confidence: 99%

Gender-Related Discrepancies in Short-Term Outcomes in Patients Undergoing Off-Pump Coronary Artery Bypass Grafting Surgery

Krasivskyi

Djordjevic

Ivanov

et al. 2023

JCM

Self Cite

View full text Add to dashboard Cite

The sex differences in patients undergoing off-pump coronary artery bypass grafting (OPCAB) surgery are still unclear. Our aim was to investigate the impact of gender on short-term outcomes in males and females after off-pump bypass procedures. Our research was designed as a double-center retrospective analysis. Generally, 343 patients (men (n = 255) and women (n = 88)) who underwent an OPCAB procedure were included in our study. To provide a statistical analysis of unequal cohorts, we created a propensity score-based matching (PSM) analysis (men, n = 61; women, n = 61). The primary endpoint was all-cause in-hospital mortality. Dialysis, transient ischemic attack (TIA), low cardiac output syndrome (LCOS), reoperation due to postoperative bleeding, wound infection and duration of hospital stay were secondary outcomes in our analysis. No significant differences were detected within the male and female groups regarding age (p = 0.116), BMI (p = 0.221), diabetes (p = 0.853), cardiogenic shock (0.256), STEMI (p = 0.283), NSTEMI (p = 0.555) and dialysis (p = 0.496). Males underwent significantly more frequently (p = 0.005) total-arterial revascularization with T-graft technique (p = 0.005) than females. In contrast, temporary pacer use was significantly higher (p = 0.022) in females compared to males. The in-hospital mortality rate was not significantly higher (p = 0.496) in the female group compared to the male group. Likewise, secondary outcomes did not differ significantly between the non-adjusted and the adjusted groups. Based on our findings, gender has no impact on short-term outcomes after OPCAB surgery.

show abstract

“…Існують різні думки щодо впливу статі на інфекційні ускладнення у ділянці грудини після операції. Деякі дослідження показали відсутність впливу статі на поширеність глибокої стернальної ранової інфекції після кардіохірургічного втручання [9]. У нашій вибірці більшість були чоловіками -10 (83,3 %).…”

unclassified

VAC Therapy as Part of Complex Treatment of Deep Sternal Wound Infection in Cardiosurgical Patients: First Experience

Osaulenko,

Chmul,

Budagov

2023

ujcvs

View full text Add to dashboard Cite

The aim. To improve the immediate and long-term results of treatment of cardiac surgery patients, by determining the feasibility of using wound therapy with negative pressure (vacuum assisted closure [VAC] therapy) as part of the complex tactics of postoperative management of patients with deep sternal wound infection (DSWI). Materials and methods. A single-center, retrospective, observational study of the clinical data of 12 patients who underwent open-heart surgery using median sternotomy and who developed a DSWI was conducted. The mean age of the patients was 66.2 ± 2.2 years. The patients were divided into 2 groups, depending on the type of the treatment they received: group 1 included 5 (41.67%) subjects with the installation of a flow-washing system; group 2 included 7 (58.33%) subjects receiving negative pressure wound therapy. Results. The use of VAC therapy contributed to the reduction of all indicators characterizing the course of the wound process, compared to patients treated with traditional methods. The duration of hospitalization was 36.2 ± 3.3 days in group 1 and 42 ± 4.0 days in group 2. The level of in-hospital mortality in the studied group receiving negative pressure wound therapy was 14.29% (1 patient) versus 80% (4 patients) in the group with flow-irrigation drainage. Conclusions. Deep sternal wound infection is a very serious postoperative complication in cardiac surgical patients with a high in-hospital mortality rate. Diabetes mellitus, obesity, immunopathies are the main risk factors. VAC therapy in patients with DSWI allows to adequately repair the wound in a shorter time while maintaining the patient’s mobility, as well as to significantly reduce the duration of wound drainage and, as a result, the length of hospitalization.

show abstract

Sex-Associated Differences in Short-Term Outcomes in Patients with Deep Sternal Wound Infection after Open-Heart Surgery

Cited by 3 publications

References 42 publications

The Impact of Gender and Age in Obese Patients on Sternal Instability and Deep-Sternal-Wound-Healing Disorders after Median Sternotomy

The Impact of Gender and Age in Obese Patients on Sternal Instability and Deep-Sternal-Wound-Healing Disorders after Median Sternotomy

Gender-Related Discrepancies in Short-Term Outcomes in Patients Undergoing Off-Pump Coronary Artery Bypass Grafting Surgery

VAC Therapy as Part of Complex Treatment of Deep Sternal Wound Infection in Cardiosurgical Patients: First Experience

Contact Info

Product

Resources

About