Management of Deep Median Sternotomy Wound Infection after Open Heart Surgery

Abstract

Background: Deep sternal wound infection (DSWI) is a rare but potentially devastating complication of median sternotomy performed in cardiac surgery. The incidence of DSWI is reported to be between 0.2% and 3%. Identifying high-risk patients and strategies to optimize risk factors plays an important role in reducing the incidence of DSWI.
Objective: This retrospective prospective study was designed to evaluate the management of deep median sternotomy wound infection after open heart surgery as regard the risk factors, rate and the outcome of its surgical treatment in Cardiothoracic Surgery Department, Mansoura University Hospital.
Patients and methods: This retrospective prospective observational study was conducted in Cardiothoracic Surgery Department at Mansoura University Hospitals from January 2016 to December 2019. The data were obtained from 24 retrospective patient and 7 prospective patients. 31 patients had DSWI and treated surgically, the incidence was 2.9%.
Results: We found that 16 (51.6%) patients were males and 15 (48.4 %) were females. The mean age was 58.23±7.898 (year), minimal age was 40 year and the maximal was 71 years. The mean BMI was 32.18 ±5.364. 14 (45.16%) of patients had diabetes mellitus (D.M). 18 (58.06%) patients were hypertensive. 10 (32.3%) patients were smokers. 51.6% of patients had coronary artery bypass graft (CABG). The most common causative organism was MRSA in 35% of patients.
Conclusion: Using of vacuum and pectoral flap in DSWI management is more effective with better healing, higher success rate and less mortality.