Prevalence of Sternal Wound Infections and Saphenous Harvesting Site Infection in Patients Undergoing Coronary Artery Bypass Graft Surgery

Document Type : Original Article

Authors

1 Department of Cardiovascular Surgery, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran

2 Student Research Committee, Faculaty of Medicine , Islamic Azad University, Mashhad Branch, Mashhad, Iran

3 Razavi Cancer Research Center, Razavi Hospital, Imam Reza International University, Mashhad, Iran.

4 International Baccalaureate Student, Victoria Park collegiate Institute, Toronto, Canada.

Abstract

Introduction: Surgical site infection is a risky complication following coronary artery bypass graft (CABG) surgery that may increase mortality and morbidity. Hence, it seems that further investigation regarding this complication may be necessary, in order to improve prevention and treatment processes.
Objective: The aim of this study was to determine the frequency of sternal wound infection and saphenous vein wound infection in patients undergoing CABG and its correlation with the determinants.
Methods: This is a cross-sectional study that was undertaken from 2015 to 2019 on 2459 patients undergoing CABG surgery with off-pump and on-pump methods. Demographic and background information of our patients were recorded. After infection, secretions were sampled and cultured.
Results: Results of the study showed that the frequency of sternal and saphenous harvesting site infection in patients was 3.7% (n=91), and these infections were often diagnosed two weeks after surgery (50 patients, 54.9%). Age and sex were identified as two significant risk factors of surgical site infection after CABG surgery (p=0.0001). Most patients came back with an infection two weeks after surgery (54.9%). Gram-positive bacteria had the greatest role in infection (35.2%) with Staphylococcus epidermidis acting as the predominant strain (n=13).
Discussion and Conclusion: The results suggested that two factors with a crucial role in the incidence of infection, are female gender and age of 50-60 years old. Diabetes, previously identified in the literature as a risk factor for surgical site infection, did not have a significant effect in this study and further research is warranted.

Keywords

References

1. Bainey, K.R, B.I. Jugdutt, Increased burden of coronary artery disease in South Asians living in North America. 
Need for an aggressive management algorithm. Atherosclerosis, 2009. 204(1): p. 1-10.
2. Barengo, N.C, Tenschi Y, Moltchanov V, Laatikamen T., Jousilahti P, Tuomilehto J. Coronary heart disease incidence and mortality, and all-cause mortality among diabetic and non-diabetic people according to their smoking 
behavior in Finland. Tob Induc Dis. 2017; 15: 12. doi: 10.1186/s12971-017-0113-3.
3. Clark, A., DesMeules, M., Luo, W. et al. Socioeconomic status and cardiovascular disease: risks and implications for care. Nat Rev Cardiol 6, 712–722 (2009). https://doi.org/10.1038/nrcardio.2009.163
4. Sanchis-Gomar F, Perez-Quilis C, Leischik R, Lucia A. Epidemiology of coronary heart disease and acute coronary syndrome. Ann Transl Med. 2016 Jul; 4(13): 256. doi: 10.21037/atm.2016.06.33. 
5. Jameson, J.L., Harrison's principles of internal medicine. 2018: McGraw-Hill Education.
6. Bhatnagar P, Wiokramasinghe K, Wiliams J, Rayner M, Townsend M. The epidemiology of cardiovascular disease 
in the UK 2014. Heart, 2015. 101(15): p. 1182-1189.
7. Reiser M, Scherag A, Forstner C, Brunkhorst F.M, Harbarth S, Doenst T, et al. Effect of pre-operative octenidine 
nasal ointment and showering on surgical site infections in patients undergoing cardiac surgery. J Hosp Infect. 2017 
Feb;95(2):137-143. doi: 10.1016/j.jhin.2016.11.004.
8. Si D, Rajmokan M, Lakhan P, Marquess J, Coulter Ch, Paterson D. Surgical site infections following coronary artery bypass graft procedures: 10years of surveillance data. BMC Infect Dis. 2014 Jun 10;14:318.doi: 10.1186/1471-
2334-14-318.
9. Sá, M.P.B.O, Ferraz P.E, Soares A.F, Miranda R.G, Araújo M.L, Silva F.V, et al. Development and validation 
of a stratification tool for predicting risk of deep sternal wound infection after coronary artery bypass grafting 
at a Brazilian hospital. Braz J Cardiovasc Surg. Jan-Feb 2017;32(1):1-7.doi: 10.21470/1678-9741-2016-0030.
10. Martorell C., Engelman R, Corl A, Brown R.B, et al. Surgical site infections in cardiac surgery: an 11-year perspective. Am J Infect Control. 2004 Apr;32(2):63-8. doi: 10.1016/j.ajic.2003.09.005.
11. Abdou E., Westercamp M, Girgis S, Sabry M, Sayyouh O, Talaat M. Sternal surgical site infection in Egypt following coronary artery bypass graft surgery: incidence and risk factors. J Hosp Infect. 2018 Dec;100(4):456-458.
doi: 10.1016/j.jhin.2018.07.001.
12. Sharif-Kashani B., Shahabi P, Mandegar M.H, Saliminejad L, Bikdeli B, Behzadnia N, et al. Smoking and 
wound complications after coronary artery bypass grafting. J Surg Res. 2016 Feb;200(2):743-8. doi: 10.1016/j.
jss.2015.09.017.
13. Frenette C., Frenette Ch, Sperlea D, Tesolin J, Patterson C, Thirion D.J. Influence of a 5-year serial infection 
control and antibiotic stewardship intervention on cardiac surgical site infections. Am J Infect Control. 2016 Sep 
1;44(9):977-82. doi: 10.1016/j.ajic.2016.02.029
Razavi International Journal of Medicine
Volume 9, Issue 3
July 2021
Pages 1-4

Files

Share

How to cite

Statistics