Sternal wound infection following CABG: a review of 1121 patients

ABSTRACT

To know incidence of sternal wound infection, microbacteria involved and associated risk factors so as practical steps should be made before hand to counter theses problems. Case series study. This study was conducted at Ch. Pervaiz Ellahi, Institute of Cardiology, Multan from 2012-2014. Microbiological testing was conducted under supervision of a consultat microbiologist attached to the hospitals performing cardiac surgery. Infections were classified as in-hospital SSIs if occurring during the hospital stay, or post-discharge. Infections were recorded as sternal or harvest site infections. Associated Potential risk factors were recorded. A proforma was filled which was approved by hospital ethical committee. Over the study period, 1121 patients had CABG. Predominantly patients were male [mostly in age range of 50-76 with median age of 63 years]. ASA score of 3 was recorded in majority of patients. The majority of patients were recorded as having an ASA score of 3 or 4, a clean wound, and antibiotic prophylaxis administered. Antibiotic prophylaxis in almost all cases.97 patients had sternal site infections, with one half of the cases detected in-hospital and the other half post-discharge. Gram-positive bacteria were detected in 56% of cases having infections. 43% had Gram-negative bacteria and fungi [e.g. Candida albicans] 1 case. The incidence of MRSA is increasing and to counter these we had to adopt methods: