Academic Journal
Impact of delayed sternal closure on wound infections following neonatal and infant cardiac surgery
| العنوان: | Impact of delayed sternal closure on wound infections following neonatal and infant cardiac surgery |
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| المؤلفون: | Maria von Stumm, Yola Leps, Luca Jochheim, Victoria van Rüth, Urda Gottschalk, Goetz Mueller, Rainer Kozlik-Feldmann, Mark G. Hazekamp, Joerg S. Sachweh, Daniel Biermann |
| المصدر: | PLoS ONE, Vol 17, Iss 5 (2022) |
| بيانات النشر: | Public Library of Science (PLoS), 2022. |
| سنة النشر: | 2022 |
| المجموعة: | LCC:Medicine LCC:Science |
| مصطلحات موضوعية: | Medicine, Science |
| الوصف: | Objectives Delayed sternal closure is a routine procedure to reduce hemodynamic and respiratory instability in pediatric patients following cardiac surgery, particularly in neonates and infants. In this setting, the possible links between sternal wound infection and delayed sternal closure are still a matter of debate. As a part of our routine, there was a low threshold for delayed sternal closure, so we reviewed our experience with sternal wound infections with a focus on potentially related perioperative risk factors, particularly delayed sternal closure. Methods We retrospectively identified 358 operated neonates (37%) and infants (mean age 3.6 months) in our local congenital heart disease database between January 2013 and June 2017. Potential risk factors for sternal wound infections, such as age, gender, complexity (based on Aristotle- and STS-EACTS mortality category), reoperation, use of cardiopulmonary bypass, extracorporeal membrane oxygenation, mortality and delayed sternal closure (163/358, 46%), were subjected to uni- and multivariate analysis. Results A total of 26/358 patients (7.3%) developed a superficial sternal wound infection. There were no deep sternal wound infections, no mediastinitis or sepsis. Applying univariate analysis, the prevalence of sternal wound infections was related to younger age, more complex surgery and delayed sternal closure. However, in multivariate analysis, sternal wound infection was only associated with delayed sternal closure (p = 0.013, odds ratio 8.6). Logistic regression revealed the prevalence of delayed sternal closure to be related to younger age, complexity, and the use of extracorporeal membrane oxygenation. Conclusion In patients younger than one year, sternal wound infections are clearly related to delayed sternal closure. However, in our cohort, all sternal wound infections were superficial and acceptable, considering the improved postoperative hemodynamic stability. |
| نوع الوثيقة: | article |
| وصف الملف: | electronic resource |
| اللغة: | English |
| تدمد: | 1932-6203 |
| Relation: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9126390/?tool=EBI; https://doaj.org/toc/1932-6203 |
| URL الوصول: | https://doaj.org/article/36c5ee47007f401683f2e7458818eb5e |
| رقم الانضمام: | edsdoj.36c5ee47007f401683f2e7458818eb5e |
| قاعدة البيانات: | Directory of Open Access Journals |
Full Text Finder | تدمد: | 19326203 |
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