Risk factors and treatment of deep sternal wound infection after cardiac operation.

摘要: Objective: Although deep sternal wound infection (DSWI) after cardiac surgery is infrequent, its consequences are serious. The purposes of this study were to define the risk factors, and establish best surgical treatment for DSWI. Methods: Retrospective analysis 863 patients who underwent was performed. divided into DSWI group (n=17) non-infection (n=846). Preoperative, perioperative, postoperative variables compared between two groups using univariate multivariate logistic regression analysis. modality also analyzed. Results: incidence 1.97%. Independent predictors concomitant coronary artery bypass grafting (CABG) with valve or aortic [odds ratio, 4.1; 95% confidence interval, (1.1, 15.1)] use intraaortic balloon pumping [4.4, (1.6, 12.3)]. An independent predictor in isolated CABG emergency operation [10.9, (2.7, 44.7)]. Four 17 died. Methicillin-resistant Staphylococcus aureus (MRSA) cultured from 10 (58.8%) patients, all four deceased subjects died infection. Seventeen treated by debridement, primary closure, addition an omentum muscle flap if necessary. Conclusions: Patients poor perioperative condition at high development It difficult treatment, owing small series study. Mortality morbidity due MRSA high. (Ann Thorac Cardiovasc Surg 2003; 9: 226‐32)