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, Faculty 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

Open Access Policy: This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited. To view a copy of this licence, visit https://creativecommons.org/licenses/by/4.0/

References

1. Bainey, K.R, B.I. Jugdutt, Increased burden of coronaryartery disease in South Asians living in North America.Need for an aggressive management algorithm. Atherosclerosis,2009. 204(1): p. 1-10.
https://doi.org/10.1016/j.atherosclerosis.2008.09.023
PMid:18980768
 
2. Barengo, N.C, Tenschi Y, Moltchanov V, LaatikamenT., Jousilahti P, Tuomilehto J. Coronary heart disease incidenceand mortality, and all-cause mortality among diabeticand non-diabetic people according to their smokingbehavior in Finland. Tob Induc Dis. 2017; 15: 12. doi:10.1186/s12971-017-0113-3.
https://doi.org/10.1186/s12971-017-0113-3
PMid:28184182 PMCid:PMC5288994
 
3. Clark, A., DesMeules, M., Luo, W. et al. Socioeconomicstatus and cardiovascular disease: risks and implicationsfor care. Nat Rev Cardiol 6, 712-722 (2009). https://doi.org/10.1038/nrcardio.2009.163
https://doi.org/10.1038/nrcardio.2009.163
PMid:19770848
 
4. Sanchis-Gomar F, Perez-Quilis C, Leischik R, LuciaA. Epidemiology of coronary heart disease and acute coronarysyndrome. Ann Transl Med. 2016 Jul; 4(13): 256.doi: 10.21037/atm.2016.06.33.
https://doi.org/10.21037/atm.2016.06.33
PMid:27500157 PMCid:PMC4958723
 
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 diseasein the UK 2014. Heart, 2015. 101(15): p. 1182-1189.
https://doi.org/10.1136/heartjnl-2015-307516
PMid:26041770 PMCid:PMC4515998
 
7. Reiser M, Scherag A, Forstner C, Brunkhorst F.M, HarbarthS, Doenst T, et al. Effect of pre-operative octenidinenasal ointment and showering on surgical site infections inpatients undergoing cardiac surgery. J Hosp Infect. 2017Feb;95(2):137-143. doi: 10.1016/j.jhin.2016.11.004.
https://doi.org/10.1016/j.jhin.2016.11.004
PMid:28109620
 
8. Si D, Rajmokan M, Lakhan P, Marquess J, Coulter Ch,Paterson D. Surgical site infections following coronary arterybypass graft procedures: 10years of surveillance data.BMC Infect Dis. 2014 Jun 10;14:318.doi: 10.1186/1471-2334-14-318.
https://doi.org/10.1186/1471-2334-14-318
PMid:24916690 PMCid:PMC4061097
 
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 sternalwound infection after coronary artery bypass grafting at a Brazilian hospital. Braz J Cardiovasc Surg. Jan-Feb2017;32(1):1-7.doi: 10.21470/1678-9741-2016-0030.
https://doi.org/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.
https://doi.org/10.1016/j.ajic.2003.09.005
PMid:15057197
 
11. Abdou E., Westercamp M, Girgis S, Sabry M, SayyouhO, Talaat M. Sternal surgical site infection in Egypt followingcoronary artery bypass graft surgery: incidenceand risk factors. J Hosp Infect. 2018 Dec;100(4):456-458.doi: 10.1016/j.jhin.2018.07.001.
https://doi.org/10.1016/j.jhin.2018.07.001
PMid:29981777 PMCid:PMC11360105
 
12. Sharif-Kashani B., Shahabi P, Mandegar M.H, SaliminejadL, 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.
https://doi.org/10.1016/j.jss.2015.09.017
PMid:26541686
 
13. Frenette C., Frenette Ch, Sperlea D, Tesolin J, PattersonC, Thirion D.J. Influence of a 5-year serial infection control and antibiotic stewardship intervention on cardiacsurgical site infections. Am J Infect Control. 2016 Sep 1;44(9):977-82. doi: 10.1016/j.ajic.2016.02.029.
https://doi.org/10.1016/j.ajic.2016.02.029
PMid:27125912
Razavi International Journal of Medicine
Volume 9, Issue 3
July 2021
Pages 1-4

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