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Audit of 37 cases of deep sternal wound infections (DSWIs) following 2418 coronary artery bypass graftings (CABGs)

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Indian Journal of Thoracic and Cardiovascular Surgery Aims and scope Submit manuscript

Abstract

Aim

The purpose of this paper is to study the incidence of deep sternal wound infections (DSWIs) after median sternotomy, its correlation to demographic data, diabetes mellitus (DM), choice of vessels used for coronary artery bypass grafting (CABG), microbiological wound status, and outcome of surgical management in terms of complete wound healing, postoperative stay, and mortality.

Methods

A total of 2418 patients who underwent CABG through median sternotomy from January 2005 to December 2013 were included in the study. DSWI was found in 37 patients. Logistic regression, Fisher’s exact test, and chi-squared test were used to find association, and a p value of <0.05 was considered as significant.

Results

Incidence of DSWI in our study is 1.53 %. In the whole population, M: F ratio was 5:1. Commonest age group of DSWI was 61 to 70 years. Out of 2418 patients, 1035 patients were diabetic, of which 31 (3 %) developed DSWI (p value 0.001). Out of these, in 1034 patients, bilateral internal mammary arteries (BIMAs) were used and 30 (2.9 %) patients developed DSWI (p value 0.030). Postoperative stays were longer for patients with multiple organisms in their culture (p value 0.029). Pectoralis muscle flaps were done in 30 patients, omentum with pectoralis in 2 patients, and simple suturing in 1 patient. Median hospital stay after definitive wound closure was 8 days. Wound healing was achieved in 79 % patients at the end of 2 weeks. Mortality after definitive wound closure was 6.06 %.

Conclusions

DM is independent risk factor for DSWI. Use of BIMA in patients with DM increases the risk of DSWI. Aggressive wound debridement and early closure is associated with low mortality and shorter hospital stay.

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Author information

Authors and Affiliations

  1. Department of Plastic Surgery, B. J. Govt. Medical College and Sassoon General Hospitals, Deenanath Hospital, Pune, India

    Parag Sahasrabudhe

  2. Department of Cardio Thorasic Surgery, Deenanath Mangeshkar Hospital, Pune, India

    Ranjit Jagtap

  3. Department of Plastic Surgery, Deenanath Mangeshkar Hospital, Pune, India

    Amit Jadhav

  4. Department of Plastic Surgery, B.J. Govt. Medical College and Sassoon General Hospital, Pune, India

    Nikhil Panse

  5. Department of Cardiothoracic Anesthesia, Deenanath Mangeshkar Hospital, Pune, India

    Nilesh Juvekar

  6. Department of Microbiology, Deenanath Hospital, Pune, India

    Sampada Patwardhan

Authors
  1. Parag Sahasrabudhe
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  2. Ranjit Jagtap
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  3. Amit Jadhav
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  4. Nikhil Panse
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  5. Nilesh Juvekar
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  6. Sampada Patwardhan
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Corresponding author

Correspondence to Parag Sahasrabudhe.

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Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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This study was not funded.

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The authors declare that they have no conflict of interest.

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For this type of study, formal consent is not required.

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Sahasrabudhe, P., Jagtap, R., Jadhav, A. et al. Audit of 37 cases of deep sternal wound infections (DSWIs) following 2418 coronary artery bypass graftings (CABGs). Indian J Thorac Cardiovasc Surg 32, 103–112 (2016). https://doi.org/10.1007/s12055-016-0425-6

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  • DOI: https://doi.org/10.1007/s12055-016-0425-6

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