MEDIASTINITIS AFTER STERNOTOMY - MORTALIT Y AND DURATION OF HOSPITAL STAY

The morbidity of deep sternal wound infections after sternotomy was as sessed by a case-controlled study. The 41 cases were identified by a p rospective enquiry over 4 months in 10 centres of cardiac surgery in t he Paris region. The cases were compared with 41 non-infected controls , paired by centre, age, gender, ASA anaesthetic risk, stage of cardia c failure and type of surgery. The criteria of pairing were respected in 96% of cases. The mortality was 12% in the study population and 5% in the controls. Thirty-two of the 41 cases required reoperation for t he sternal wound infection, usually to insert Redon drains after debri dement of the wound. The total duration of the hospital stay was 53 da ys in the study cases and 30 days in controls, a median prolongation o f the hospital stay of 23 days. The authors conclude that deep wound i nfection after sternotomy is responsible for almost doubling the durat ion of hospital stay, The economic consequences alone justify active r esearch into the prevention of this complication.