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首页> 外文期刊>Seminars in thoracic and cardiovascular surgery >Prevention and management of deep sternal wound infection.
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Prevention and management of deep sternal wound infection.

机译：胸骨深部伤口感染的防治。

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摘要

Deep sternal wound infection (DSWI) is an uncommon but serious complication of median sternotomy in cardiac surgery, associated with significant mortality and morbidity. We performed a retrospective review of 30,102 consecutive cardiac surgical patients operated on at our institution from 1990 to 2003 and found an incidence of DSWI of 0.77%. The in-hospital mortality rate was 6.9% for DSWI patients versus 2.8% for patients without DSWI (P = 0.0002). Multivariable predictors for development of DSWI were old age, diabetes, previous stroke or TIA, and congestive heart failure. The use of bilateral internal thoracic artery (BITA) grafts increased the risk of DSWI in patients undergoing coronary artery bypass surgery, particularly in those with congestive heart failure alone or with diabetes. Skeletonization of BITA grafts resulted in a lower risk of DSWI, comparable to nondiabetic patients (1.3% versus 1.6%, P = 0.8). Patients with DSWI were treated with either sternal debridement and primary closure or sternectomy with myocutaneous flap reconstruction, resulting in a 6-month freedom from adverse event rate of 76% in both groups.
机译：深胸骨伤口感染（DSWI）是心脏手术中正中胸骨切开术的一种罕见但严重的并发症，伴有明显的死亡率和发病率。我们对1990年至2003年在该机构接受手术的30102例心脏外科手术患者进行了回顾性研究，发现DSWI的发生率为0.77％。 DSWI患者的院内死亡率为6.9％，而无DSWI的患者为2.8％（P = 0.0002）。 DSWI发展的多变量预测因素是老年，糖尿病，先前的中风或TIA和充血性心力衰竭。在进行冠状动脉搭桥手术的患者中，特别是在患有充血性心力衰竭或糖尿病的患者中，使用双侧胸腔内动脉（BITA）移植物会增加DSWI的风险。与非糖尿病患者相比，BITA移植物的骨骼化可降低DSWI的风险（1.3％对1.6％，P = 0.8）。 DSWI患者经过胸骨清创术和原发性闭合或采用带皮瓣重建术的tern骨切除术治疗，两组的6个月内无不良事件发生率达到76％。

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