Background
Postoperative sternal wound infections are a potentially devastating complication
following cardiac surgery. The aim of our study was to determine risk factors associated
with patients' baseline characteristics and peri- and postoperative management for
the development of surgical site infections (SSIs) after cardiac surgery involving
sternotomy.
Methods
Since 2009 the University Hospital of Basel, a tertiary care center in Switzerland,
has participated in the national SSI-surveillance program by conducting postdischarge
surveillance. We conducted a nested case-control study involving 30 consecutive patients
with an organ/space SSI after cardiac surgery and 60 control patients.
Results
Receipt of antibiotics before operation (odds ratio [OR], 1.20; 95% confidence interval
[CI], 1.02-1.41; P = .032), decreased albumin levels (OR, 0.87; 95% CI, 0.76-0.99; P = .040, respectively), time on extracorporal circulation (OR, 1.02; 95% CI, 1.00-1.03;
P = .012), number of drainages (OR, 9.15; 95% CI, 2.01-41.76; P = .004), length of drain retention (OR, 1.44; 95% CI, 1.10-1.90; P = .009), and resuscitation (OR, 7.30; 95% CI, 1.53-34.71; P = .012) were associated with SSIs. Incidence density drainage days—accounting for
both number of drains and length of retention—were the only independent risk factor
(OR, 1.12; 95% CI, 1.02-1.11; P = .018).
Conclusions
Retention of drainages in the operative site longer than 48 hours was the only independent
risk factor for the development of organ/space sternal wound infections after cardiac
surgery.
Key Words
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Article info
Publication history
Published online: July 18, 2013
Footnotes
Conflicts of interest: None to report.
Identification
Copyright
© 2013 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc. All rights reserved.
