Surgical-site infections within 60 days of coronary artery by-pass graft surgery

Swenne, Christine Leo; Lindholm, Christina; Borowiec, Jan; Carlsson, Marianne

doi:10.1016/j.jhin.2004.02.005

Cited by 63 publications

(74 citation statements)

References 32 publications

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“…Reoperation for bleeding was defined as reoperation to control bleeding within 36 h following the initial surgery. Superficial wound infection was recognized based on the definition of the US Centers for Disease Control and Prevention [18]. …”

Section: Methodsmentioning

confidence: 99%

Incidence of Deep Sternal Wound Infection in Diabetic Patients Undergoing Off-Pump Skeletonized Internal Thoracic Artery Grafting

Ding

Ji²,

Shi³

et al. 2015

Cardiology

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Objectives: To evaluate the impact of skeletonized bilateral or single internal thoracic artery (ITA) grafting on the risk of deep sternal wound infection (DSWI) in diabetic patients undergoing off-pump coronary artery bypass grafting (OPCAB). Materials and Methods: A total of 803 diabetic patients undergoing OPCAB surgery from January 2010 to December 2014 were enrolled into this study and assigned to the pSITA group (patients undergoing pedicled single ITA grafting, n = 362), the sSITA group (skeletonized single ITA grafting, n = 295), or the sBITA group (skeletonized bilateral ITA grafting, n = 146). The primary end point was the diagnosis of a DSWI. Results: Eighteen patients developed postoperative DSWI, with an incidence of 2.2%. Patients in the sSITA group had a significantly lower incidence of DSWI than those in the pSITA group (1.0 vs. 3.6%, p = 0.0408). In multivariate logistic regression analysis, the risk of DSWI in the sSITA group was 0.41 times that in the pSITA group. Conclusions: sSITA grafting lowered the risk of DSWI in diabetic patients undergoing OPCAB surgery compared to pSITA grafting. Multicenter clinical trials involving larger sample sizes are needed to determine the merit of pSITA grafting in reducing the risk of DSWI following OPCAB surgery.

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Section: Methodsmentioning

confidence: 99%

Incidence of Deep Sternal Wound Infection in Diabetic Patients Undergoing Off-Pump Skeletonized Internal Thoracic Artery Grafting

Ding

Ji²,

Shi³

et al. 2015

Cardiology

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“…Preoperative factors associated with increased incidence of SV infection include increased age, 10,11 female sex, 9,12-14 increased body mass index, 9,10,13,[14][15][16] and comorbidities such as DM, 9,[11][12][13]17 PVD, [11][12][13] low preoperative hemoglobin levels, 14 congestive heart failure, and chronic renal failure, whereas the peroperative factors include duration of surgery, open technique of harvesting, 1,18-21 harvesting from the leg with deep vein thrombosis, inappropriate use of electrocautery, and IABP use, and these factors are modifiable.…”

Section: Risk Factors Associated With Gsvhsimentioning

confidence: 99%

Saphenous vein harvest wound complications: risk factors, identification, prevention, and management

Siddiqi¹

2016

CWCMR

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Coronary artery bypass grafting is a commonly performed surgery worldwide that gives good results. Great saphenous vein is used as a conduit for bypass in over 95% cases. The harvesting technique has remained unchanged over the years. However, wound complications from harvesting the great saphenous vein by open method can be a major source of postoperative morbidity. With the objective of preventing major complications, identification of risk factors for saphenous vein harvest site infection is important. It is imperative to develop approaches that prevent infection and to allow for early recognition of patients who are at high risk and who may need more watchful monitoring so as to prevent development of wound complications. It is desirable to assess the patient completely, delineate the anatomy of peripheral vessels particularly in a patient with associated peripheral vascular disease, identify the best site to perform the saphenous vein harvest incision, employ a meticulous surgical technique, recognize complications early, and start the recommended treatment without delay. The aim of this paper is to identify the risk factors for saphenous vein harvest site complications and their identification, prevention, and management.

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“…For example, Junkers et al found that even up to 30% of such infections may occur after discharge between the 30 th and 90 th day after the operation [18]. On the other hand, Swenne et al published the results of a study in which approximately 95% of sternal infections were observed in the early postoperative period of up to 30 days after surgery [19]. Moreover, we enrolled in our study not only patients undergoing coronary artery bypass grafting, but also patients undergoing valvular or combined procedures.…”

Section: Discussionmentioning

confidence: 99%

QUALITY IN MEDICINE Comparative analysis of the antiseptic effectiveness of two commercially available skin disinfectants in cardiac surgery – a preliminary report

Perek¹,

Lipski²,

Stefaniak³

et al. 2013

kitp

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StreszczenieWstęp: Kluczowe znaczenie w zapobieganiu zakażeniom rany po operacjach serca ma właściwa dezynfekcja skóry klatki piersiowej. Cel pracy: Porównawcza ocena skuteczności dwóch komercyjnie dostępnych roztworów do odkażania ran. Materiał i metody: Badaniem objęto kolejnych 91 chorych w wieku 66,2 ±9,9 roku poddanych planowym operacjom serca. W grupie H (n = 46) stosowano 70-procentowy roztwór alkoholu etylowego z chlorheksydyną (Hibitanem), w grupie B (n = 45) 50% roztwór alkoholu propylowego z polimerem winylopirolidonu i jodyną (Braunodermem). Za twardy kliniczny punkt końcowy przyjęto infekcję rany pooperacyjnej (głęboką lub powierzchowną) w okresie do 30 dni po zabiegu. Porówny-wano liczbę leukocytów (WBC), stężenie białka C-reaktywnego (C-reactive protein -CRP) oraz prokalcytoniny (PCT) przed operacją, 24, 48, 72 godziny i 7 dni po operacji oraz maksymalne ich wartości (WBC max , CRP max , PCT max ) w kolejnych pomiarach. Wyniki: Twardy punkt końcowy badania osiągnęły 4 osoby (8,9%) z grupy B i 2 (4,3%) z grupy H. W jednym przypadku stwierdzono głęboką infekcję z zajęciem mostka (w grupie B). Wartości wszystkich analizowanych parametrów hematologicznych wzrosły po operacji i były istotnie (p < 0,05) wyż-sze w grupie B niż w grupie H (WBC max 15,2 ±2,9 vs 14,1 ±2,4; CRP max 190,4 ±41,0 vs 112,7 ±35,2 mg/l i PCT max 1,92 ±0,81 vs 0,95 ±0,34 μg/l, odpowiednio w grupie B i H). Wnioski: Wyniki badania mogą wskazywać, że 70-procentowy roztwór alkoholu etylowego z chlorheksydyną skuteczniej zapobiega wczesnym zakażeniom rany po operacjach serca niż 50-procentowy roztwór alkoholu propylowego z polimerem winylopirolidonu i jodyną. Słowa kluczowe: odkażanie skóry, chlorheksydyna, zakażenie rany chirurgicznej.Kardiochirurgia i Torakochirurgia Polska 2013; 10 (2) 177 QUALITY IN MEDICINE AbstractIntroduction: Appropriate antisepsis of the chest skin is key for successful prophylaxis against incisional surgical site infections in cardiac surgery. Aim of the study: Comparative analysis of the antiseptic effectiveness of two commercially available agents. Material and methods: The study involved 91 consecutive patients at the mean age of 66.2 ±9.9 years who underwent elective cardiac surgery. In order to disinfect the chest skin, chlorhexidine (Hibitan) in 70% ethanol was used in group H (n = 46) and povidone-iodine (Braunoderm) in 50% propanol was used in group B (n = 45). The primary clinical endpoint was the occurrence of incisional surgical site infection (either deep or superficial) within the first 30 days after the elective surgery. Moreover, leukocyte counts (WBC) as well as C-reactive protein (CRP) and procalcitonin (PCT) concentrations were analyzed preoperatively and postoperatively -24, 48, 72 hours, and 7 days after the operation. Additionally, peak values of the aforementioned laboratory parameters (WBC max , CRP max and PCT max ) were also estimated in the consecutive measurements. Results: The primary study endpoint was reached by 4 (8.9%) group B and 2 (4.3%) group H patients. In a single case from...

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Surgical-site infections within 60 days of coronary artery by-pass graft surgery

Cited by 63 publications

References 32 publications

Incidence of Deep Sternal Wound Infection in Diabetic Patients Undergoing Off-Pump Skeletonized Internal Thoracic Artery Grafting

Incidence of Deep Sternal Wound Infection in Diabetic Patients Undergoing Off-Pump Skeletonized Internal Thoracic Artery Grafting

Saphenous vein harvest wound complications: risk factors, identification, prevention, and management

QUALITY IN MEDICINE Comparative analysis of the antiseptic effectiveness of two commercially available skin disinfectants in cardiac surgery – a preliminary report

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