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Analysis of Risk Factors for Sternal Surgical Site Infection Emphasizing the Appropriate Ventilation of the Operating Theaters

Published online by Cambridge University Press:  21 June 2016

Serap Simsek Yavuz*
Affiliation:
Departments of Infectious Disease and Clinical Microbiology, Siyami Ersek Thoracic and Cardiovascular Surgery Hospital, Uskudar, Istanbul, Turkey
Yesim Bicer
Affiliation:
Anesthesiology and Reanimation, Siyami Ersek Thoracic and Cardiovascular Surgery Hospital, Uskudar, Istanbul, Turkey
Nihan Yapici
Affiliation:
Anesthesiology and Reanimation, Siyami Ersek Thoracic and Cardiovascular Surgery Hospital, Uskudar, Istanbul, Turkey
Sibel Kalaca
Affiliation:
Department of Public Health, School of Medicine, Marmara University, Haydarpasa, Istanbul, Turkey
Osman Ozcan Aydin
Affiliation:
Anesthesiology and Reanimation, Siyami Ersek Thoracic and Cardiovascular Surgery Hospital, Uskudar, Istanbul, Turkey
Gercek Camur
Affiliation:
Cardiovascular Surgery, Siyami Ersek Thoracic and Cardiovascular Surgery Hospital, Uskudar, Istanbul, Turkey
Funda Kocak
Affiliation:
Departments of Infectious Disease and Clinical Microbiology, Siyami Ersek Thoracic and Cardiovascular Surgery Hospital, Uskudar, Istanbul, Turkey
Zuhal Aykac
Affiliation:
Anesthesiology and Reanimation, Siyami Ersek Thoracic and Cardiovascular Surgery Hospital, Uskudar, Istanbul, Turkey
*
Sevki Ozengin Sk. Ercan Apt. No: 16/4 81090 Erenkoy/Istanbul, ([email protected])

Abstract

Objective.

To determine the incidence of and identify risk factors for sternal surgical site infection (SSI).

Design.

Prospective cohort study. Data on potential risk factors, including the type of operating theater and infection data, were collected prospectively and analyzed by multivariate analysis.

Setting.

Siyami Ersek Thoracic and Cardiovascular Surgery Hospital, a 700-bed teaching hospital and the largest center for cardiac surgery in Turkey. The cardiothoracic unit performs approximately 3,000 cardiac operations per year.

Patients.

All adult patients who underwent cardiac surgery with sternotomy between January 14, 2002, and July 1, 2002, and who survived at least 4 days after surgery were included in the study.

Results.

Potential risk factor data were complete for 991 patients. There was sternal SSI in 41 patients (4.1%). Female sex, diabetes mellitus, operation performed in the older operating theaters, and duration of procedure exceeding 5 hours were identified as independent risk factors for sternal SSI.

Conclusions.

Female and diabetic patients are at higher risk for sternal SSI and should be followed up carefully after cardiac surgery to prevent the development of sternal SSI. Reducing the duration of surgery could reduce the rate of postoperative sternal SSI. The operating theater environment may have an important role in the pathogenesis of sternal SSI, and appropriate ventilation of the operating theaters would be critical in the prevention of sternal SSI.

Type
Original Articles
Copyright
Copyright © The Society for Healthcare Epidemiology of America 2006

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