Hostname: page-component-78c5997874-j824f Total loading time: 0 Render date: 2024-11-19T04:51:56.576Z Has data issue: false hasContentIssue false
  • English
  • Français

Postoperative Wound Infections Following Cardiac Surgery: Significance of Contaminated Cases Performed in the Preceding 48 Hours

Published online by Cambridge University Press:  02 January 2015

Malkanthie I. deSilva  and
J. Peter Rissing
Malkanthie I. deSilva*
Affiliation:
Veterans Administration Medical Center and theMedical College of Georgia, Augusta, Georgia
J. Peter Rissing
Affiliation:
Veterans Administration Medical Center and theMedical College of Georgia, Augusta, Georgia
*
Medical Center Epidemiologist, VA Medical Center (111G), Augusta, GA 30910
Get access Rights & Permissions [Opens in a new window]

Abstract

Postoperative wound infections following open heart cardiac surgery increased markedly after hospital relocation (7 of 77 v; 4 of 320; p = .0007). Of the multiple identified risk factors, significant patient and procedural association included prolonged operative time of infected patients (384 minutes ± 115 SD v 318 ± 67, p = .025) and operation in a room used within the previous 48 hours for a contaminated case (4/7 infected v 10/67 not infected; p = .023). Several defects were discovered in the air handling system. After appropriate changes, the infection rate decreased in the next 12 months (1 of 109; p < .02). Other concurrent surgical wound infection rates remained unchanged suggesting that defective air handling may have impacted only on the open heart cardiac surgery patients. Preceding contaminated surgery and prolonged operative time were associated with postoperative wound infections in cardiac surgery.

Type
Original Articles
Information
Infection Control & Hospital Epidemiology , Volume 5 , Issue 8 , August 1984 , pp. 371 - 377
Copyright
Copyright © The Society for Healthcare Epidemiology of America 1984

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1.Engelman, RM, Williams, CD, Couge, TH, et al: Mediastinitis following open-heart surgery. Review of two years' experience. Arch Surg 1973;107:722–778.CrossRefGoogle ScholarPubMed
2.Weinstein, RA, Jones, EL, Schwarzmann, SW, et al: Sternal osteomyelitis and mediastinitis after open-heart operation: Pathogenesis and prevention. Ann Thorac Surg 1976;21:442–444.CrossRefGoogle ScholarPubMed
3.Culliford, AT, Cunningham, JN, Zeff, RH, et al: Sternal and cos-tochondral infections following open-heart surgery. A review of 2,594 cases. J Thorac Cardiovasc Surg 1976;72:714–726.CrossRefGoogle Scholar
4.Sherry, C, Bleck, PC, Javid, H, et al: Sternal wound complications management and results. J Thorac Cardiovasc Surg 1980;80:861–867.CrossRefGoogle Scholar
5.Delaria, GA, Hunter, JA, Goldin, MD, et al: Leg wound complications associated with coronary revascularization. J Thorac Cardiovasc Surg 1981;81:403–407.CrossRefGoogle ScholarPubMed
6.Howard, JM, Barker, WF, Culbertson, WR, et al: Postoperative wound infections: The influence of ultraviolet irradiation of the operating room and various other factors. Ann Surg 1964;160(suppl): 1–192.Google Scholar
7.Altemeier, WA, Surgical infections: Incisional wounds, in Bennett, JV, Brachman, PS (eds): Hospital Infections. Boston, Little Brown & Company, 1979, pp 287–306.Google Scholar
8.American College of Surgeons Committee on Control of Surgical Infections: Manual on Control oflnfections in Surgical Patients. Philadelphia, JB Lippincott, 1976, pp 20–31.Google Scholar
9.Woodside, JR, Borden, TA, Sterilization of vinyl bags for preparation of ice slush solution for hypothermic renal surgery. Urology 1978;11:273.CrossRefGoogle ScholarPubMed
10.Pierce, SB, Shank, RA, Duncan, REet al: Slush technique in renal surgery. AORN 1977;25:223.CrossRefGoogle Scholar
11.Centers for Disease Control: National Nosocomial Infections Study Report. Annual Summary. Atlanta, 1977.Google Scholar
12.Aber, RC, Garner, JS, Postoperative wound infections, in Wenzel, RP (ed): Handbook of Hospital Acquired Infections. Boca Raton, FL, CRC Pressine, 1981, pp 303–316.Google Scholar
13.Haley, RW, Hooton, TM, Culver, DH, et al: Nosocomial infections in US hospitals 1975-1976. Estimated frequency by selected characteristics of patients. Am J Med 1981;70:947–959.CrossRefGoogle ScholarPubMed
14.Bruun, J, Postoperative wound infection. Pre-disposing factors and the effect of a reduction in the dissemination of staphylococci. Acta Med Scand 1970;514(suppl): 1–89.Google Scholar
15.Seropian, R, Reynolds, BM, Wound infection after preoperative depilatory versus razor preparation. Am J Surg 1971;121:251–254.CrossRefGoogle ScholarPubMed
16.Sutherland, RD, Miller, OL, Martinez, HE, et al: Coronary arterial bypass operations without antibiotic coverage. Chest 1979;76:174–175.CrossRefGoogle ScholarPubMed
17.Austin, TW, Coles, JC, Burnett, R, et al: Aoriocoronaiy by-pass procedures and sternotomy infections: A study of antistaphylococcal prophylaxis. Can J Surg 1980;23:483–485.Google Scholar
18.Sanford, JP, Disinfectants that don't. Ann Intern Med 1970;72:282–283.CrossRefGoogle ScholarPubMed
19.Bruun, J, Solberg, CO, Handcarriage of gram-negative bacilli and staphylococcus aureus. Br Med J 1973;2:580–582.CrossRefGoogle Scholar
20.Centers for Disease Control: Guidelines for hospital environmental control: Antiseptics, handwashing, and handwashing facilities. Infect Control 1981;2:133–137.Google Scholar
21.Moylon, JA, Balish, E, Chan, J, Intraoperative bacterial transmission. Surg Gynecol Obstet 1975;141:731–733.Google Scholar
22.Moylon, JA, Kennedy, BV, The importance of gown and drape barriers in the prevention of wound infection. Surg Gynecol Obstet 1980;151:465–470.Google Scholar
23.Simmons, BP, CDC guidelines for prevention of surgical wound infections. Infect Control 1982;3:187–196.CrossRefGoogle Scholar