Risk factors of deep sternal wound infections in coronary artery bypass graft surgery

Background. Major infections of sternal wounds after coronary artery bypass graft surgery (CABG) occur infrequently, but when they do, they contribute substantial morbidity and mortality, We identified significant risk factor s of deep sternal wound infection (DSWI) following CABG and hoped to plan p rophylactic measures for high risk patients in order to reduce the incidenc e of infection. Methods. From 1996 to 1997, a total of 620 patients received CABG at a medi cal center in Taiwan. The surgical wound was examined every day, Wound infe ctions were defined and classified according to Centers for Diseases Contro l (CDC) definitions, DSWI, were defined as those involving the mediastinum, bone or cartilage, and infections beneath the subcutaneous tissue. Several risk factors were analyzed. Results, We identified 17 (2.7%) DSWI). Univariate analysis indicated that ASA scores, surgical risk index, surgeon, postoperative low cardiac output, re-operation for bleeding, re-wiring of sternum, length of postoperative s tay in the intensive care unit, postoperative duration of mechanical ventil ation, operation time, duration of cardiopulmonary bypass. independent pred ictors by multivariate logistic regression analysis were re-operation for b leeding and operation time, A total of 16 organisms were isolated among 14 patients. Staphylococcus accounted for most isolates (93.8%) and the most o f them were methicillin-resistant (80%). Conclusions. Re-operation for bleeding and operation time were the independ ent predictors.