Open Chest Duration Following Congenital Cardiac Surgery Increases Risk for Surgical Site Infection.

Autor: Iguidbashian J; Department of Surgery, University of Colorado School of Medicine, 12605 E 16th Ave, Aurora, CO, 80045, USA. John.Iguidbashian@cuanschutz.edu., Feng Z; Department of Surgery, University of Colorado School of Medicine, 12605 E 16th Ave, Aurora, CO, 80045, USA., Colborn KL; Department of Surgery, University of Colorado School of Medicine, 12605 E 16th Ave, Aurora, CO, 80045, USA., Barrett CS; Department of Cardiology and Cardiothoracic Surgery, Children's Hospital of Colorado, Aurora, CO, USA., Newman SR; Department of Cardiology and Cardiothoracic Surgery, Children's Hospital of Colorado, Aurora, CO, USA., Harris M; Department of Cardiology and Cardiothoracic Surgery, Children's Hospital of Colorado, Aurora, CO, USA., Campbell DN; Department of Cardiology and Cardiothoracic Surgery, Children's Hospital of Colorado, Aurora, CO, USA., Mitchell MB; Department of Cardiology and Cardiothoracic Surgery, Children's Hospital of Colorado, Aurora, CO, USA., Jaggers J; Department of Cardiology and Cardiothoracic Surgery, Children's Hospital of Colorado, Aurora, CO, USA., Stone ML; Department of Cardiology and Cardiothoracic Surgery, Children's Hospital of Colorado, Aurora, CO, USA.
Jazyk: angličtina
Zdroj: Pediatric cardiology [Pediatr Cardiol] 2024 Aug; Vol. 45 (6), pp. 1284-1288. Date of Electronic Publication: 2022 Dec 30.
DOI: 10.1007/s00246-022-03088-4
Abstrakt: Surgical site infections (SSI) following congenital heart surgery (CHS) remain a significant source of morbidity. Delayed sternal closure (DSC) is often required to minimize the potential for hemodynamic instability. The purpose of this study was to determine the incidence of SSI among patients undergoing DSC versus primary chest closure (PCC) and to define a potential inflection point for increased risk of SSI as a function of open chest duration (OCD).A retrospective review of our institutional Society of Thoracic Surgeons dataset is to identify patients undergoing CHS at our institution between 2015 and 2020. Incidences of SSI were compared between DSC and PCC patients. DSC patients were evaluated to determine the association of OCD and the incidence of SSI.2582 operations were performed at our institution between 2015 and 2020, including 195 DSC and 2387 PCC cases. The incidence of SSI within the cohort was 1.8% (47/2,582). DSC patients had significantly higher incidences of SSI (17/195, 8.7%) than PCC patients (30/2387, 1.3%, p < 0.001). Further, patients with an OCD of four or more days had a significantly higher incidence of SSI (11/62, 17.7%, p = 0.006) than patients with an OCD less than 4 days (6/115, 5.3%).The incidence of SSI following CHS is higher in DSC patients compared to PCC patients. Prolonged OCD of 4 days or more significantly increases the risk of SSI and represents a potentially modifiable risk factor for SSI predisposition. These data support dedicated, daily post-operative assessment of candidacy for chest closure to minimize the risk of SSI.
(© 2022. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)
Databáze: MEDLINE
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