Preventing deep wound infection after coronary artery bypass grafting: a review.

摘要: The consequences of deep wound infections before, during, and after coronary artery bypass grafting have prompted research to clarify risk factors explore preventive measures keep infection rates at an irreducible minimum. An analysis 42 studies in which investigators used multivariate logistic regression revealed that diabetes mellitus obesity are by far the chief preoperative factors. A 4-point scoring system based on a patient's body mass index presence or absence is one practical way determine mediastinitis, other risk-estimate methods being refined. Intraoperative include prolonged perfusion time, use more internal mammary arteries as grafts, blood transfusion, mechanical circulatory assistance. postoperative factor reoperation, usually for bleeding. Unresolved issues optimal approach Staphylococcus aureus nasal colonization choice prophylactic antibiotic regimen. We recommend cardiac surgery programs supplement their audit processes ongoing vigilance with periodic, multidisciplinary reviews best-practice standards preoperative, intraoperative, patient care.