Surgical-Site Infection After Cardiac Surgery: Incidence, Microbiology, and risk Factors

Lepelletier, Didier; Perron, Stéphanie; Bizouarn, Philippe; Caillon, Jocelyne; Drugeon, H; Michaud, Jean-Luc; Duveau, D.

doi:10.1086/502569

Cited by 121 publications

(99 citation statements)

References 38 publications

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“…In our study, however, the most observed episode of Table 4. Microorganism spread by site of infection HCRI was surgical site infection (20.0%), an incidence rate higher than other studies, whose range varies from 3.5% to 6.5% [7,11]. Also, we found a long preoperative time in heart transplant recipients.…”

Section: Discussioncontrasting

confidence: 45%

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Health care-related infections in solid organ transplants

et al. 2007

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The health care-related infections are well-known in a critical care setting, but reports of those infections in solid organ transplanted patients are scarce. We developed a study of retrospective cohort in a tertiary teaching hospital for 14 months. Eighty-one patients underwent solid organ transplants. The global incidence of health care-related infection was 42.0%. Fifteen percent of the cases were occurrences of surgical site infections, 14.0% pneumonias, 9.0% primary blood stream infections, 4.0% urinary tract infections and 2.0% skin infection. The most prevalent etiologic agents were K. pneumoniae (8.6%), P. aeruginosa (7.4%); A. baumannii (5.0%) and S. aureus (2.5%). Mortality was 18.0%, none of then related to health care infections. The high rate of those infections, mainly surgical site infections, suggests a demand for stricter measures to prevent and control health care-related infections.

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Section: Discussioncontrasting

confidence: 45%

“…In kidney and double kidney and pancreas transplantation, a low incidence of urinary tract infection was found, which was the most common infection complication related in the literature [11,13]. However, in the double kidney and pancreas transplantation we found, again, a high incidence of surgical site infection.…”

Section: Discussionmentioning

confidence: 66%

Health care-related infections in solid organ transplants

et al. 2007

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“… SSI (surgical site infections) are one of the primary complications of concern following cardiothoracic surgery, with the incidence at about 3% in the general population [1]. However, this risk is doubled in patients with post-operative hyperglycemia, defined as BG (blood glucose) > 200 mg/dL following surgery through POD (post-operative day) 2 [2].…”

Section: Introductionmentioning

confidence: 99%

“…In 2003, the CMS (Centers for Medicare and Medicaid Services) and the CDC (Centers for Disease Control and Prevention) established the SCIP (Surgical Care Improvement Project) to help reduce post-surgical complications. Based on studies suggesting tight glycemic control can reduce the incidence of SSI [1][2][3][4][5], these guidelines recommend to maintain BG < 200 mg/dL through 6:00 on POD 2 [6].…”

Section: Introductionmentioning

confidence: 99%

Evaluation of Glycemic Control with a Pharmacist-Managed Post-Cardiothoracic Surgery Insulin Protocol

Fung¹,

Tom²,

Chiang³

2015

JPP

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Purpose: The purpose of this study is to validate whether a standardized pharmacist-managed protocol improves glycemic control in post-operative patients following cardiothoracic surgery. Methods: The study was conducted via retrospective chart review comparing outcomes from patients treated before and after implementation of a pharmacist-managed insulin protocol. The primary efficacy outcome is defined as the percentage of patients below the target blood glucose level of 200 mg/dL from POD (post-operative day) 1 through POD 2, with secondary outcomes comparing the rates of hypoglycemia, hospital LOS (length of stay), and the incidences of SSI (surgical-site infections) diagnosed through 30 days post-surgery. Eligible participants included all adult patients who had undergone cardiothoracic surgery during the time frame of the study, but excluded any patients requiring intubation or continuous insulin infusion through 12:00 on POD 1. Results: The incidence of post-operative hyperglycemia was similar in the pre-protocol and post-protocol groups with a non-statistically significant trend toward a lower incidence in the post-protocol (19.5% pre-protocol v 12.3% post-protocol, P = 0.05). There were no statistically significant differences between both groups with regard to SSI (2.1% vs 4.7%, P = 0.16), hospital LOS (9.9 days vs 9.6 days, P = 0.46), or hypoglycemia (0.5% vs 2.1%, P = 0.05). Conclusion: The pharmacist-managed insulin protocol resulted in similar rates of post-operative hyperglycemia compared to the pre-protocol group.

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“…However, this technique is not yet performed as a current practice, by arguing that the use of ITA would be associated with more morbidity, increased need for hemotransfusion [5], increasing probability of transoperative myocardial infarction [6] and, in particular, sternal osteomyelitis [7][8][9][10].…”

Section: Introductionmentioning

confidence: 99%

Diabéticos devem ter a artéria torácica interna esqueletizada? Avaliação da perfusão esternal por cintilografia

Filho¹,

Neto²,

Silva³

et al. 2009

Rev Bras Cir Cardiovasc

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Objective: To assess, by scintillography, the effect of using bilateral internal thoracic arteries (BITAs) -prepared by two different techniques -on the sternal perfusion.Method: 35 patients undergone coronary artery bypass grafting (CABG) were divided into two groups: Group A (18) had both ITA's dissected using skeletonization technique and group B (17) as pedicle preparation. There was no difference in the two groups relating gender, age and demographic characteristics. On the 7 th postoperative day the patients underwent bone scintillography. The statistical analysis was performed using the Student's t test with 95% significance.Results: Group A (skeletonized ITA) showed higher perfusion (11.5%) of the sternum as a mean, than Group B (pedicled ITA) patients; however this was not statistically significant (P = 0.127). On the other hand, comparing the 004).Conclusions: 1 -Sternal perfusion is not affected significantly apart from the dissection technique used for both internal thoracic arteries in the general population when assessed by bone scintillography. 2 -In the diabetic subgroup, a significant preservation of the sternal perfusion was observed in patients undergone skeletonized dissection of the internal thoracic arteries. Although these findings should be confirmed in a greater number of cases, diabetic patients should have the internal thoracic arteries dissected using skeletonization techinque.Descriptors: Sternum. Mammary arteries. Tomography, emission-computed. 158SANTOS FILHO, EC ET AL -Should the diabetics have the internal thoracic artery skeletonized? Assessment of sternal perfusion by scintillography Bras Cir Cardiovasc 2009; 24(2): 157-164 Rev

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Surgical-Site Infection After Cardiac Surgery: Incidence, Microbiology, and risk Factors

Cited by 121 publications

References 38 publications

Health care-related infections in solid organ transplants

Health care-related infections in solid organ transplants

Evaluation of Glycemic Control with a Pharmacist-Managed Post-Cardiothoracic Surgery Insulin Protocol

Diabéticos devem ter a artéria torácica interna esqueletizada? Avaliação da perfusão esternal por cintilografia

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