Deep Sternal Wound Infection: Diagnosis, Treatment and Prevention

被引：64
作者：
Phoon, Priscilla Hui Yi [1 ,2 ]
Hwang, Nian Chih [1 ,2 ]
机构：
[1] Singapore Gen Hosp, Dept Anaesthesiol, Singapore, Singapore
[2] Natl Heart Ctr, Dept Cardiothorac Anaesthesia, Singapore, Singapore
来源：
JOURNAL OF CARDIOTHORACIC AND VASCULAR ANESTHESIA | 2020年 / 34卷 / 06期
关键词：
sternal instability; wound dehiscence; cardiac surgery; prevention; treatment; management of mediastinitis; INTERNAL THORACIC ARTERY; VACUUM-ASSISTED CLOSURE; SURGICAL-SITE INFECTION; OPEN-HEART-SURGERY; POST-STERNOTOMY MEDIASTINITIS; PREDICTIVE SCORING SYSTEM; CORONARY-BYPASS SURGERY; LONG-TERM SURVIVAL; RISK-FACTORS; CARDIAC-SURGERY;
D O I：
10.1053/j.jvca.2019.09.019
中图分类号：
R614 [麻醉学];
学科分类号：
100217 ;
摘要：
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. Management of DSWI can be complex and may require a multidisciplinary team approach involving infectious disease specialists, microbiologists, as well as cardiothoracic and plastic surgeons. Early detection, appropriate antibiotic treatment, aggressive surgical debridement, and use of regional muscle flaps have significantly improved treatment outcomes. (C) 2019 Elsevier Inc. All rights reserved.
引用
收藏
页码：1602 / 1613
页数：12
相关论文
共 140 条
[11]   Transfusion increases the risk of postoperative infection after cardiovascular surgery [J].
Banbury, MK ;
Brizzio, ME ;
Rajeswaran, J ;
Lytle, BW ;
Blackstone, EH .
JOURNAL OF THE AMERICAN COLLEGE OF SURGEONS, 2006, 202 (01) :131-138
[12]   Skeletonized versus pedicled internal thoracic artery and risk of sternal wound infection after coronary bypass surgery: meta-analysis and meta-regression of 4817 patients [J].
Barros de Oliveira Sa, Michel Pompeu ;
Ferraz, Paulo Ernando ;
Escobar, Rodrigo Renda ;
Vasconcelos, Frederico Pires ;
Bandeira Ferraz, Alvaro Antonio ;
Braile, Domingo Marcolino ;
Lima, Ricardo Carvalho .
INTERACTIVE CARDIOVASCULAR AND THORACIC SURGERY, 2013, 16 (06) :849-857
[13]   Development and Validation of a Stratification Tool for Predicting Risk of Deep Sternal Wound Infection after Coronary Artery Bypass Grafting at a Brazilian Hospital [J].
Barros Oliveira Sa, Michel Pompeu ;
Ferraz, Paulo Ernando ;
Soares, Artur Freire ;
Albuquerque Miranda, Rodrigo Gusmao ;
Araujo, Mayara Lopes ;
Silva, Frederico Vasconcelos ;
Lima, Ricardo de Carvalho .
BRAZILIAN JOURNAL OF CARDIOVASCULAR SURGERY, 2017, 32 (01) :1-7
[14]  
Bindu Barkha, 2017, J Anaesthesiol Clin Pharmacol, V33, P306, DOI 10.4103/joacp.JOACP_334_16
[15]   Deep sternal infections after in situ bilateral internal thoracic artery grafting for left ventricular myocardial revascularization: predictors and influence on 20-year outcomes [J].
Bonacchi, Massimo ;
Prifti, Edvin ;
Bugetti, Marco ;
Parise, Orlando ;
Sani, Guido ;
Johnson, Daniel M. ;
Cabrucci, Francesco ;
Gelsomino, Sandro .
JOURNAL OF THORACIC DISEASE, 2018, 10 (09) :5208-+
[16]   Skeletonized internal thoracic artery harvest reduces pain and dysesthesia and improves sternal perfusion after coronary artery bypass surgery: A randomized, double-blind, within-patient comparison [J].
Boodhwani, Munir ;
Lam, B. Khanh ;
Nathan, Howard J. ;
Mesana, Thierry G. ;
Ruel, Marc ;
Zeng, Wanzhen ;
Sellke, Frank W. ;
Rubens, Fraser D. .
CIRCULATION, 2006, 114 (08) :766-773
[17]   Deep sternal wound infection: Risk factors and outcomes [J].
Borger, MA ;
Rao, V ;
Weisel, RD ;
Ivanov, J ;
Cohen, G ;
Scully, HE ;
David, TE .
ANNALS OF THORACIC SURGERY, 1998, 65 (04) :1050-1056
[18]  
Bratzler Dale W., Clinical Practice Guidelines for Antimicrobial Prophylaxis in Surgery
[19]  
Brunet F, 1996, J THORAC CARDIOV SUR, V111, P1200
[20]  
Bryan CS, 2013, TEX HEART I J, V40, P125
12345678910