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Objective To explore the clinical significance of distribution of ABO blood group in patients with deep sternal wound infection(DSWI)after cardiac surgery.Methods Clinical data of 84 patients with DSWI after cardiac surgery in the department of cardiothoracic surgery in General Hospital of China Aviation of China Medical University in 2012-2014 were analyzed retrospectively, according to ABO blood group, patients were divided into 4 groups:A blood group, B blood group, AB blood group, and O blood group, according to whether the blood group was A group, they were divided into A blood group and non-A blood group.Distribution of ABO blood group in DSWI patients was analyzed, risk factors, clinical manifestations, and etiological characteristics of DSWI patients with different ABO blood groups were compared.Results Among patients with DSWI, A blood group and non-A blood group were 33 cases(39.3％)and 51 cases(60.7％)respectively(B, O, and AB blood group were 16 cases[19.1％], 29 cases[34.5％], and 6 cases[7.1％]respectively);the proportion of A blood group in DSWI patients was higher than that of the healthy population, but the difference was not statistically significant(P=0.055). Distribution of baseline characteristics and incidences of various clinical manifestations among DSWI patients of different blood groups were not statistically significant(all P＞0.05).However, compared with non-A blood group or other ABO blood groups, DSWI patients with A blood group had higher incidence of elevated white blood cell count, difference was statistically significant(P＜0.05), positive detection rate of gram-positive bacteria in A blood group was also higher, difference was statistically significant(P＜0.05).In addition, only 3 strains of Pseudomonas aeruginosa was detected only in B blood group, while gram-negative bacteria were not detected in AB blood group. Conclusion ABO blood group may play a role in the pathogenesis of DSWI after cardiac surgery, which may be associated with a specific bacterial infection.
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Objective To investigate the clinical features and pathogenic characteristics of different types of deep sternal wound infection in dif?ferent types after cardiac surgery. Methods A retrospective study was performed. From January 2012 to December 2014,84 patients with sec?ondary DSWI after cardiac surgery underwent the pectoralis major muscle flap transposition in our department were recruited for the study. Re?sults The average age of 84 patients with DSWI was 54.6 ± 14.8 years old,of which typeⅡDSWI patients were the most common(49/84, 58.3%). Both typeⅠand typeⅡDSWI patients showed typical clinical manifestations and early chest X?ray or Computerized tomography(CT) showed mediastinal widening(P0.05),but the pathogenic results of the 3 types of those DSWI patients showed such a trend:typeⅠDSWI patients with GNB is was more common,and typeⅡDSWI patients was more prone to complicated infection. Conclusion Different types of DSWI may dis?play different features,the prevention and treatment of DSWI should be closely combined with the clinical manifestations and local pathogenic char?acteristics.
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BACKGROUND: This study aimed to evaluate the therapeutic results and safety of pectoralis major muscle turnover flaps in the treatment of mediastinitis after coronary artery bypass grafting (CABG) procedures. METHODS: Data regarding 33 patients with post-CABG deep sternal wound infections (DSWIs) who underwent pectoralis major muscle turnover flap procedures in the Emam Reza and Ghaem Hospitals of Mashhad, Iran were reviewed in this study. For each patient, age, sex, hospital stay duration, remission, recurrence, and associated morbidity and mortality were evaluated. RESULTS: Of the 2,447 CABG procedures that were carried out during the time period encompassed by our study, DSWIs occurred in 61 patients (2.5%). Of these 61 patients, 33 patients (nine females [27.3%] and 24 males [72.7%]) with an average age of 63+/-4.54 years underwent pectoralis major muscle turnover flap placement. Symptoms of infection mainly occurred within the first 10 days after surgery (mean, 10.24+/-13.62 days). The most common risk factor for DSWIs was obesity (n=16, 48.4%) followed by diabetes mellitus (n=13, 39.4%). Bilateral and unilateral pectoralis major muscle turnover flaps were performed in 20 patients (60.6%) and 13 patients (39.4%), respectively. Complete remission was achieved in 25 patients (75.7%), with no recurrence in the follow-up period. Four patients (12.1%) needed reoperation. The mean hospitalization time was 11.69+/-6.516 days. Four patients (12.1%) died during the course of the study: three due to the postoperative complication of respiratory failure and one due to pulmonary thromboembolism. CONCLUSION: Pectoralis major muscle turnover flaps are an optimal technique in the treatment of post-CABG mediastinitis. In addition to leading to favorable therapeutic results, this flap is associated with minimal morbidity and mortality, as well as a short hospitalization time.