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Efficacy of new multimodal preventive measures for post-operative deep sternal wound infection

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Abstract

Background

Deep sternal wound infection (DSWI) is a critical complication of cardiovascular surgery. This study aimed to confirm the efficacy of new, multimodal preventive measures for post-operative DSWI.

Methods

From January 2008 to December 2012, 1240 patients underwent cardiovascular surgery via median sternotomy at our hospital. The patients were divided into two groups according to the period in which surgery was performed: those treated before and those treated after January 2011, which was when we implemented the new preventive measures against DSWI. The preventive measures included routine use of an off-pump technique in coronary artery bypass grafting, higher body temperature of pump cases, screening and pre-operative eradication of nasal methicillin-resistant Staphylococcus aureus colonization, and use of a microbial sealant. We compared the incidence of DSWI between the two time periods. Univariate and multivariate analyses were also performed for the entire period to identify DSWI risk factors.

Results

Only 1 case (0.2%) of DSWI was noted among 554 patients in the latter period while 25 patients (3.6%) experienced DSWI among the 686 patients in the earlier period (p < 0.0001). The risk factors for DSWI were body mass index (BMI) ≥ 25 kg/m2 and operation time ≥ 8 h.

Conclusions

We observed a marked decrease in the incidence of DSWI after the implementation of multimodal preventive measures. The risk factors for DSWI were BMI ≥ 25 kg/m2 and operation time ≥ 8 h.

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Acknowledgements

All authors would like to thank Noriko Shinkai for prevention and management of SSIs in our hospital. She also supported data collection for this article.

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Authors and Affiliations

  1. Department of Cardiovascular Surgery, Kobe City Medical Center General Hospital, 2-1-1, Minatojima-minamimachi, Chuoku, Kobe, 6500047, Japan

    Yasunobu Konishi, Naoto Fukunaga, Ken Nakamura & Tadaaki Koyama

  2. Department of Cardiac Surgery, Nagoya University Graduate School of Medicine, Kobe, Japan

    Yasunobu Konishi & Akihiko Usui

  3. Division of Cardiovascular Surgery, Department of General Surgical Science, Gunma University, Kobe, Japan

    Tomonobu Abe

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  1. Yasunobu Konishi
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  2. Naoto Fukunaga
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  3. Tomonobu Abe
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  4. Ken Nakamura
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  5. Akihiko Usui
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  6. Tadaaki Koyama
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Correspondence to Yasunobu Konishi.

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Konishi, Y., Fukunaga, N., Abe, T. et al. Efficacy of new multimodal preventive measures for post-operative deep sternal wound infection. Gen Thorac Cardiovasc Surg 67, 934–940 (2019). https://doi.org/10.1007/s11748-019-01139-x

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  • DOI: https://doi.org/10.1007/s11748-019-01139-x

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