%0 Journal Article
%T Deep Sternal Wound Infections after Coronary Artery Bypass Grafting: Analysis of 29 Cases from Iraq
%A Raghda Basil Ismael Alkhateeb
%A Asmaa Saleem Esmail Ah-Ghurabi
%A Laith Saleh Alkaaby
%A Abdulsalam Y. Taha
%J World Journal of Cardiovascular Surgery
%P 153-172
%@ 2164-3210
%D 2022
%I Scientific Research Publishing
%R 10.4236/wjcs.2022.127012
%X <span style=\"font-family:Verdana;\">Background: Deep sternal wound infection (DSWI), or
mediastinitis, is a devastating complication of coronary artery bypass grafting
(CABG). This prospective study aimed to assess our management of DSWI in view
of the published literature. Methods: Over 2-years (ending </span><span style=\"font-family:Verdana;\">in</span><span style=\"font-family:&quot;\"><span style=\"font-family:Verdana;\"> January 2016), 29
patients (20 males) developed DSWI amongst 520 patients who underwent standard
CABG surgeries (5.6%). Pre-, intra- and postoperative variables were
documented. Whenever possible, the infections were culture-verified. Besides
antibiotics, patie</span><span style=\"font-family:Verdana;\">nts received one or more
of the following therapies: drainage, debridement, closed irrigation, sternal
re-wiring, vacuum</span></span><span style=\"font-family:Verdana;\">-</span><span style=\"font-family:Verdana;\">assisted closure (VAC)</span><span style=\"font-family:Verdana;\">,</span><span style=\"font-family:Verdana;\"> and
bone resection. Results: </span><span style=\"font-family:Verdana;\">the </span><span style=\"font-family:&quot;\"><span style=\"font-family:Verdana;\">male to female ratio was 2.2:1.
Mean age was 58.1 ¡À 7.3 years. The mean body mass index (BMI) was 27.9 ¡À 3.4
kg/m</span><sup><span style=\"font-family:Verdana;\">2</span></sup><span style=\"font-family:Verdana;\">. There were 18, 16 and 11 patients with diabetes mellitus
(DM), hypertension and chronic obstructive pulmonary disease (COPD)
respectively. Cardiopulmonary bypass (CPB) was utilized in 26 (89.7%) patients
with a mean time of 117.5 ¡À 23.3 minute</span></span><span style=\"font-family:Verdana;\">s</span><span style=\"font-family:Verdana;\">.
Most surgeries (n = 21, 72.4%) lasted 5</span><span style=\"font-family:&quot;\"> </span><span style=\"font-family:Verdana;\">-</span><span style=\"font-family:&quot;\"> </span><span style=\"font-family:Verdana;\">6 hrs. According to Pairolero classification, there were 3 (10.3%) Type
I, 22 (75.9%) Type II and 4 (13.8%) Type III infections. Four (13.8%) cases
were culture-verified. Twenty-three (79.3%) DSWIs were surgically managed.
Sternal re-wiring was performed in 14 (48.3%) cases while VAC was added to
other therapies in 2 (6.9%) patients. DSWIs completely resolved in 18 (62.0%)
patients within 3</span><span style=\"font-family:&quot;\"> </span><span style=\"font-family:Verdana;\">-</span><span style=\"font-family:&quot;\"> </span><span style=\"font-family:Verdana;\">24 weeks wh</span><span
%K Deep Sternal Wound Infection
%K Mediastinitis
%K Coronary Artery Bypass Grafting
%K Median Sternotomy
%K Vacuum-Assisted Closure
%K Wound Debridement
%U http://www.scirp.org/journal/PaperInformation.aspx?PaperID=118869