Trends in postcoronary artery bypass graft sternal wound dehiscence in a provincial population

Risk factors for post sternotomy wound complications across the patient journey: A systematised review of the literature

“…Much of the literature examining SSIs has focused on pre-operative aspects of patient demographics and comorbidities. Female gender, 19,22,27,36 ; age over 70 years 4,18,21,29,31,33 obesity 30 , diabetes, smoking status, and COPD 13 30 have all been identified as factors associated with increased risk of developing SSIs, both in uni-and multi-variant analysis. The interaction between these factors are complex and multifaceted.…”

“…Out of the 25 papers reporting multivariant analysis, nineteen identified high body mass index as a key risk factor for an SSI 15,[18][19][20][21][22][23][24][25][26][27][28][29][30][31][32][33][34] . Gender was highlighted in six papers, with female gender reported as a risk factor for developing SSI in five, with one reporting that female gender was associated with higher risk of sternal wound dehiscence 19 ; and the others reporting SSIs 4,22,35,27 . One study identified male gender as a risk factor for deep sternal wound infection 29 .…”

“…Ten studies identified diabetes as a risk factor, although differentiation between type I and II diabetes was not always made 15,[19][20][21][22][23][25][26][27] . In addition, one study highlighted the increased risk associated with post operative hyperglycaemia in non diabetic patients 32 .…”

“…An increased risk of sternal dehiscence 26 ; and deep sternal wound infection 15 were identified as a risk associated with diabetes. Two studies found that the higher risk of SSI was equally applicable to insulin dependent and non-insulin dependent diabetic patients 4,19 , including the risk of sternal wound dehiscence. 19 Patients presenting with chronic obstructive pulmonary disease or with a history of lung disease were at higher risk of developing surgical site infection 4 , sternal wound infection 27 , sternal wound dehiscence 18,26 , mediastinitis 30 and deep sternal wound infection.…”

“…Two studies found that the higher risk of SSI was equally applicable to insulin dependent and non-insulin dependent diabetic patients 4,19 , including the risk of sternal wound dehiscence. 19 Patients presenting with chronic obstructive pulmonary disease or with a history of lung disease were at higher risk of developing surgical site infection 4 , sternal wound infection 27 , sternal wound dehiscence 18,26 , mediastinitis 30 and deep sternal wound infection. 29,36 Arterial hypertension was also identified as a risk factor for developing SSWI, and patients with pulmonary hypertension were at higher risk of developing DSWI 23 .…”