INVESTIGATION OF DEEP STERNAL WOUND INFECTION AFTER CORONARY ARTERY BYPASS GRAFT AND ITS RISK FACTORS
- نوع فایل : کتاب
- زبان : انگلیسی
- مؤلف : Mohammad Javad Hoseini1, Mohammad Naseri2, Mojtaba Teimoori3
- چاپ و سال / کشور: 2008
Description
Objective: To investigate factors that predict sternal wound complications in patients after coronary artery bypass grafting (CABG) because prediction of deep sternal wound infection after surgery, might help us to do some interventions and reduce its consequences. Methodology: The record of all these patients was reviewed retrospectively. DSWI was defined according to the guidelines of the Centers for Disease Control and Prevention. From Sep 2003 to Sep 2006 a total of 1014 patients who underwent coronary bypass graft surgery in a cross-sectional study was included in this study. Results: Logistic regression analysis was conducted and the risk factors that significantly predicted sternal wound complications after coronary artery bypass graft surgery included older age, Diabetes mellitus, increasing BMI, and in class three or four of the New York Heart Association functional class. Most infections had a late and the majority of these were caused by staphylococcus epidermidis while other were pseudomonas aeroginosa, streptococcus pneumonia, staphylococcus aureus and one of them was Meticilline resistance. The clinically most fulminate infections were caused by e-coli and presented early after surgery. Conclusion: Advanced age, diabetes and obesity, NYHA high score were the important risk factors identified. As such we suggest more attention should be paid to these patient. Modifying the risk factor and making decision according to risk factor such as appropriate administration of prophylactic antibiotic in patient with poor physical status, good control diabetes are recommended.
Pak J Med Sci 2008 Vol. 24 No. 2 Received for Publication: November 24, 2007 * Accepted: January 17, 2008
