TOWARD FURTHER REDUCING WOUND INFECTIONS IN CARDIAC OPERATIONS

Background. Serious wound infections such as mediastinitis still occur at a rate of 0.8% to 2.0%, according to the most recently published c ardiac operative series. Methods. Data from careful surveillance for i nfection have been collected prospectively during a 4.5-year period on 1,717 patients who underwent cardiac operations performed under direc t ultraviolet C radiation. Results. The rate for mediastinitis was 0.2 3%, and for deep incisional infection without mediastinitis, 0.12%; th ese rates are significantly lower than those for eight of nine of the most recently published cardiac series. When our infection rates were stratified using the National Nosocomial Infection Surveillance risk i ndex, they were also significantly lower in the most important risk ca tegories than the corresponding stratified rates collected from the pa rticipating hospitals of the Centers for Disease Control and Preventio n National Nosocomial Infection Surveillance system. Conclusions. Thou gh we lack the proof that only a large, randomized study might provide , certainly, one possible explanation for our lower wound infection ra te was the use of bactericidal ultraviolet C radiation during operatio n. This is a simple and effective means of minimizing operating room a irborne bacteria as one possible source of these infections.