Surgical site infection after delayed sternal closure in neonates with congenital heart disease: retrospective case-control study

Abstract

Objectives To determine the prevalence of surgical site infections (SSIs) in neonatal congenital heart disease patients undergoing delayed sternal closure (DSC) and evaluate risk factors for SSI. Methods Hospital records of 483 consecutive neonates who underwent surgical intervention between January 2013 and December 2017 were reviewed, and perioperative variables were recorded. Results We found that the prevalence of SSI was 87.5% when the body weight was less than 1500 g. When the operative age was between seven and 14 days, the probability of no SSI is about 93.9%. When the duration of the aortic cross-clamp was more than 60 min, the prevalence of SSI was 91.2%. The prevalence without SSI was 96.6% when the duration of DSC was less than 24 h. However, when the duration of DSC was more than 120 h, the prevalence of SSI was 88.9% (p = 0.000). Conclusions With the prolongation of aortic clamping duration, the probability of occurrence of SSI increased in neonatal CHD with DSC. The age at operation and body weight are closely related to the occurrence of SSI in neonatal CHD patients with DSC.

A meta‐analysis showing the effect of surgical site wound infections and associated risk factors in neonatal surgeries

“…A total of 17 studies reported between 2005 and 2022 satisfied the inclusion criteria for the meta‐analysis among the 1653 distinctive reports. 10 , 11 , 12 , 13 , 14 , 15 , 16 , 17 , 18 , 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 This meta‐analysis study included 18 872 neonates undergoing surgery at the beginning of the study; 1506 were with surgical site wound infections, and 17 366 were without surgical site wound infections as control. All studies evaluated surgical site wound infections' risk factors and effects in neonates undergoing surgery.…”

“…A total of 17 studies reported between 2005 and 2022 satisfied the inclusion criteria for the meta‐analysis among the 1653 distinctive reports 10‐26 . This meta‐analysis study included 18 872 neonates undergoing surgery at the beginning of the study; 1506 were with surgical site wound infections, and 17 366 were without surgical site wound infections as control.…”

“…This meta‐analysis comprised 17 studies that included 18 872 neonates undergoing surgery at the beginning of the study; 1506 of them were with surgical site wound infections, and 17 366 were without surgical site wound infections as control 10‐26 . Surgical site wound infections had significantly higher mortality, a longer length of hospital stays, and lower birthweight of neonates compared with no surgical site wound infections for neonates undergoing surgery.…”

“…This meta-analysis comprised 17 studies that included 18 872 neonates undergoing surgery at the beginning of the study; 1506 of them were with surgical site wound infections, and 17 366 were without surgical site wound infections as control. [10][11][12][13][14][15][16][17][18][19][20][21][22][23][24][25][26] Surgical site wound infections had significantly higher mortality, a longer length of hospital stays, and lower birthweight of neonates compared with no surgical site wound infections for neonates undergoing surgery. However, surgical site wound infections had no notable difference in the gestational age at birth of neonates and the preoperative antibiotic prophylaxis compared with no surgical site wound infections for neonates undergoing surgery.…”

The efficacy of nursing interventions in preventing surgical site infections in patients undergoing surgery for congenital heart disease

“…These infections not only pose an immediate health risk but also potentially impede the longterm success of surgical interventions, impacting the overall prognosis of individuals with CHD. 6,7 In addressing this critical issue, nursing interventions emerge as a pivotal component of the perioperative care framework. These interventions, encompassing a broad range of practices from preoperative preparation to postoperative care, are designed to minimize the risk of infection and promote optimal recovery.…”