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preLekára.sk / Journals / Perspectives in Surgery / 2018 - 9

Strategies preventing deep sternal wound infection in cardiac surgery − review

Česká verzia

Authors: M. Šimek 1;  R. Hájek 1;  M. Kaláb 1;  A. Klváček 2;  B. Zálešák 3
Authors place of work: Kardiochirurgická klinika Fakultní nemocnice a Univerzity Palackého v Olomouci 1;  Kardiochirurgické oddělení, Nemocnice Na Homolce 2;  Oddělení plastické a estetické chirurgie Fakultní nemocnice a Univerzity Palackého v Olomouci 3
Published in the journal: Rozhl. Chir., 2018, roč. 97, č. 9, s. 414-418.
Category: Review

Summary

Deep sternal wound infection is a feared complication of cardiac surgery due to the negative impact on mortality, morbidity and long-term survival. Its incidence has remained more or less unchanged over the last three decades despite the significant increase in patients´ morbidity and complexity of cardiac surgery. The review summaries strategies to reduce the incidence of deep sternal wound reflecting general surgical site infection prevention and specificities of surgery performed through the median sternotomy. Furthermore, contemporary evidence-based recommendations for prevention of this complication are highlighted in the review.

Key words:

sternal infection – prevention – cardiac surgery

Zdroje

  1. Cotogni P, Barbero C, Rinaldi M. Deep sternal wound infection after cardiac surgery: Evidences and controversies. World J Crit Care Med. 2015;4:265−73.

  2. Matros E, Aranki SF, Bayer LR, et al. Reduction in incidence of deep sternal wound infections: random or real? J Thorac Cardiovasc Surg 2010;139:680−5.

  3. Sousa-Uva M, Head SJ, Milojevic M, et al. 2017 EACTS Guidelines on perioperative medication in adult cardiac surgery, Eur J Cardiothorac Surg 2018;53:5–33.

  4. Finkelstein R, Rabino G, Mashiah T, et al. Vancomycin versus cefazolin prophylaxis for cardiac surgery in the setting of a high prevalence of methicillin-resistant staphylococcal infections. J Thoracic Cardiovasc Surg 2002;123:326–32.

  5. Bolon MK, Morlote M, Weber SG, et al. Glycopeptides are no more effective than beta-lactam agents for prevention of surgical site infection after cardiac surgery: a meta-analysis. Clinical Infectious Diseases 2004;38:1357–63.

  6. Hamman BL, Stout LY, Theologes TT, et al. Relation between topical application of platelet-rich plasma and vancomycin and severe deep sternal wound infections after a first median sternotomy. Am J Cardiol 2014;113:1415−9.

  7. Lazar HL, Ketchedjian A, Haime M, et al. Topical vancomycin in combination with perioperative antibiotics and tight glycemic control helps to eliminace sternal wound infections. J Thorac Cardiovasc Surg 2014;148:1035−8.

  8. Lander HL, Ejiofor JI, McGurk S, et al. Vancomycin paste does not reduce the incidence of deep sternal wound infection after cardiac operations. Ann Thorac Surg 2017;103:497−503.

  9. Friberg O, Dahlin LG, Källman J, et al. Colla­gen-gentamicin implant for prevention of sternal wound infection; long-termfollow-up of effectiveness. Interact Cardio­vasc Thorac Surg. 2009;9:454−8.

  10. Birgand G, Radu C, Alkhoder S, et al. Does a gentamicin-impregnated collagen sponge reduce sternal wound infections in high-risk cardiac surgery patients? Interact Cardiovasc Thorac Surg 2013;16:134−41.

  11. Schimmer C, Gross J, Ramm E, et al. Prevention of surgical site sternal infections in cardiac surgery: a two-centre prospective randomized controlled study. Eur J Cardiothorac Surg 2017;51:67−72.

  12. Mavros MN, Mitsikostas PK, Alexiou VG, et al. Gentamicin collagen sponges for the prevention of sternal wound infection: A meta-analysis of randomized controlled trials.J Thorac Cardiovasc Surg 2012;144:1235–40.

  13. Mishra PK, Ashoub A, Salhiyyah K, et al. Role of topical application of gentamicin containing collagen implants in cardiac surgery. J Cardiothorac Surg 2014;9:122.

  14. Bělina F. Současné možnosti ovlivnění infekce v místě chirurgického výkonu. Rozhl Chir 2017;5:189−96.

  15. Cimochowski GE, Harostock MD, Brown R, et al. Intranasal mupirocin reduces sternal wound infection after open heart surgery in diabetics and nondiabetics. Ann Thorac Surg 2001;71:1572–8.

  16. Konvalinka A, Errett L, Fong IW. Impact of treating Staphylococcus aureus nasal carriers on wound infections in cardiac surgery. J Hosp Infect 2006;64:162−8.

  17. Fowler VG, Allen KB, Moreira ED, et al. Effect of an investigational vaccine for preventing Staphylococcus aureus infections after cardiothoracic surgery: a randomized trial. JAMA 2013;309:1368−78.

  18. Ozdemir AC, Aykut K. Efficacy and safety of bone wax to reduce sternal bleeding following coronary bypass surgery. Ann Thorac Cardiovasc Surg 2014;20:213−6.

  19. Miyahara K, Matsuura A, Takemura H, et al. Implementation of bundled interventions greatly decreases deep sternal wound infection following cardiovascular surgery. J Thorac Cardiovasc Surg 2014;148:2381−8.

  20. Graf K, Sohr D, Haverich A, et al. Decrea­se of deep sternal surgical site infection rates after cardiac surgery by a comprehensive infection control program. Interact Cardiovasc Thorac Surg 2009;9:282−6.

  21. Abu-Omar Y, Kocher GJ, Bosco P, et al. European Association for Cardio-Thoracic Surgery expert consensus statement on the prevention and management of mediastinitis, European Journal of Cardio-Thoracic Surgery 2017;51:10–29.

  22. Lazar HL, Chipkin SR, Fitzgerald CA, et al. Tight glycemic control in diabetic coronary artery bypass graft patients improves perioperative outcomes and decreases recurrent ischemic events. Circulation 2004;109:1497−502.

  23. Gandhi GY, Nuttall GA, Abel MD, et al. Intensive intraoperative insulin therapy versus conventional glucose management during cardiac surgery: a randomized trial. Ann Intern Med 2008;146:233−43.

  24. Sajja LR. Strategies to reduce deep sternal wound infection after bilateral internal mammary artery grafting. Int J Surg 2015;16:171−8.

  25. Saso S, James D, Vecht JA, et al. Effect of skeletonization of the internal thoracic artery for coronary revascularization on the incidence of sternal wound infection. Ann Thorac Surg 2010;89:661−70.

  26. Ogawa S, Okawa Y, Sawada K, et al. Continuous postoperative insulin infusion reduces deep sternal wound infection in patients with diabetes undergoing coronary artery bypass grafting using bilateral internal mammary artery grafts: a propensity-matched analysis. Eur J Cardiothorac Surg 2016;49:420−6.

  27. Gatti G, Soso P, Dell‘Angela L, et al. Routine use of bilateral internal thoracic artery grafts for left-sided myocardial revascularization in insulin-dependent diabetic patients: early and long-term outcomes. Eur J Cardiothorac Surg 2015;48:115−20.

  28. Kieser TM, Rose MS, Montgomery M, et al. Toward zero: Deep sternal wound infection after 1001 consecutive coronary artery bypass procedures using arterial grafts: Implications for diabetic patiens. J Thorac Cardiovasc Surg. 2014;5:1887−95.

  29. Andreas M, Zeitlinger M, Hoeferl M, et al.Internal mammary artery harvesting influences antibiotic penetration into presternal tissue. Ann Thorac Surg 2013;95:1323−9.

  30. Nishi H, Mitsuno M, Tanaka H, et al. Decrea­sing sternum microcirculation after harvesting the internal thoracic artery. Eur J Cardiothorac Surg 2011;40:240−4.

  31. Nešpor D, Fila P, Černý J, et al. Přehled metod uzávěru střední sternotomie. Rozhl Chir 2017;94:48−56.

  32. Friberg Ö, Dahlin LG, Söderquist B, et al. Influence of more than six sternal fixation wires on the incidence of deep sternal wound infection Thorac Cardiovasc Surg 2006;54:468−73.

  33. Schimmer C, Reents W, Berneder S, et al. Prevention of sternal dehiscence and infection in high-risk patients: a prospective randomized multicenter trial. Ann Thorac Surg 2008;86:1897−904.

  34. Negri A, Manfredi J, Terrini A, et al. Prospective evaluation of a new sternal closure method with thermoreactive clips. Eur J Cardiothorac Surg 2002;22:571−5.

  35. Srivastava V, Yap CH, Burdett C, et al. Thermoreactive clips do not reduce sternal infection: a propensity-matched comparison with sternal wires. Interact Cardiovasc Thorac Surg 2015;21:699–704.

  36. Bennett-Guerrero E, Phillips-Bute B, Waweru PM, et al. Pilot study of sternal plating for primary closure of the sternum in cardiac surgical patients. Innovations 2011;6:38−8.

  37. Franco S, Herrera AM, Atehortúa M, et al. Use of steel bands in sternotomy closure: implications in high-risk cardiac surgical population. Interact Cardiovasc Thorac Surg 2009;8:200−5.

  38. Stelly MM, Rodning CB, Stelly TC. Reduction in deep sternal wound infection with use of a peristernal cable-tie closure system: a retrospective case series. J Cardiothorac Surg 2015;10:166−9.

  39. Snyder CW, Graham LA, Byers RE, et al. Primary sternal plating to prevent sternal wound complications after cardiac surgery: early experience and patterns of failure. Interact CardioVasc Thorac Surg 2009;9:763−6.

  40. Raman J, Song DH, Bolotin G, et al. Sternal closure with titanium plate fixation – a paradigm shift in preventing mediastinitis. Interact Cardiovasc Thorac Surg 2006;5:336−9.

  41. Lee JC, Raman J, Song DH. Primary sternal closure with titanium plate fixation: plastic surgery effecting a paradigm shift. Plast Reconstr Surg 2010;125:1720−4.

  42. Gorlitzer M, Wagner F, Pfeiffer S, et al. Prevention of sternal wound complications after sternotomy: results of a large prospective randomized multicentre trial. Interact Cardiovasc Thorac Surg 2013;17:515−22.

  43. Tsang W, Modi A, Ahmed I, et al. Do external support devices reduce sternal wound complications after cardiac surgery? Interact Cardiovasc Thorac Surg 2016;23:957−61.

  44. Colli A. First experience with a new negative pressure incision management system on surgical incisions after cardiac surgery in high risk patients. Journal of Cardiothoracic Surgery 2011;6:160.

  45. Grauhan O, Navasardyan A, Hofmann M, et al. Prevention of poststernotomy wound infections in obese patients by negative pressure wound therapy. J Thorac Cardiovasc Surg 2013;145:1387−92.

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Perspectives in Surgery

Číslo 9
2018 Číslo 9
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