Sternal Wound Infection Following CABG: A Review of 1121 Patients

Abstract

Objective: 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 Study Design: Case series study. Place and Duration of Study: This study was conducted at Ch. Pervaiz Ellahi, Institute of Cardiology, Multan from 2012-2014. Materials and Methods: 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. Results: 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. Conclusion: The incidence of MRSA is increasing and to counter these we had to adopt methods.