Incidence and risk factors of sternal wound infection at site of incision after open-heart surgery

Objective: To identify the incidence of sternal wound infection and the risk factors before, during and after open-heart surgery in an Iranian critical care unit. Method:A descriptive, analytic study investigating all open-heart surgery patients from March 2010 to March 2011,in terms of the incidence of sternal wound infection and the risk factors before, during, and after surgery. Patients were examined for signs of infection at the site of surgical incision on presentation to the ward, daily during their stay, and on discharge. The same investigator reviewed all wounds, every day. Results:The incidence of sternal wound infection was found to be 10%. Multivariate regression analysis identified the following risk factors: diabetes (OR: 0.439; 95%CI: 0.21-0.95; p=0.04), age (OR: 1.033; 95%CI: 1.003-1.064; p=0.03), hyperlipidaemia (OR: 1.008; 95%CI: 1.005-1.011; p < 0.001), history of respiratory disorders ([COPED] OR: 2.952; 95%CI: 1.3-6.4; p=0.007), female gender (OR: 2.06; 95%CI: 1.40-3.03; p < 0.008), and history of addiction to opiates (OR: 2.33; 95%CI: 1.56-3.49; p < 0.006). Conclusion: This study found a high rate of surgical sternal wound infection in open-heart surgery patients in an Iranian critical care unit, suggesting that the medical and care-giving team in the cardiac intensive care unit need further education.