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ID 114995
Title Alternative
Risk factors for sternal wound infection
Author
Takaku, Mitsuru The University of Tokushima
Matsuo, Shinji The University of Tokushima KAKEN Search Researchers
Harada, Hiroshi Kochi Health Sciences Center
Nagae, Hiroaki Tokushima Red Cross Hospital
Fujioka, Yusuke Kurashiki Central Hospital
Anraku, Kuniaki Matsue Red Cross Hospital
Inagawa, Kiichi Kawasaki Medical School
Keywords
Mediastinitis
Postoperative complications
Surgical flaps
Risk factors
Omentum
Content Type
Journal Article
Description
Background
Although the utility of flaps for the treatment of sternal wound infections following median sternotomy has been reported for 30 years, there have been few reports on the risk factors for complications after reconstruction. The objective of this investigation was to identify factors related to complications after the reconstruction of sternal wound infections.
Methods
A retrospective analysis of 74 patients with reconstructive surgery after sternal wound infection over a 5-year period was performed. Clinical data including age, sex, body mass index (BMI), comorbidities, bacterial culture, previous cardiac surgery, wound depth, mortality rate, type of reconstructive procedure, and complication rate were collected.
Results
The patients' BMI ranged from 15.2 to 33.6 kg/m2 (mean, 23.1±3.74 kg/m2). Wound closure complications after reconstructive surgery were observed in 36.5% of the cases. The mortality rate was 2.7%. Diabetes mellitus significantly affected the rate of wound closure complications (P=0.041). A significant difference in the number of complications was seen between Staphylococcus aureus (S. aureus) and coagulase-negative Staphylococci (P=0.011). There was a correlation between harvesting of the internal thoracic artery and postoperative complications (P=0.048). The complication rates of the pectoralis major flap, rectus abdominis flap, omentum flap, a combination of pectoralis major flap and rectus abdominis flap, and direct closure were 23.3%, 33.3%, 100%, 37.5%, and 35.7%, respectively.
Conclusions
Diabetes mellitus, S. aureus, harvesting of the internal thoracic artery, and omentum flap were significant factors for complications after reconstruction. The omentum flap volume may be related to the complications associated with the omentum flap transfer in the present study.
Journal Title
Archives of Plastic Surgery
ISSN
22346163
22346171
Publisher
Korean Society of Plastic and Reconstructive Surgeons
Volume
41
Issue
3
Start Page
253
End Page
257
Published Date
2014-05-12
Rights
This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
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language
eng
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departments
Medical Sciences