Sternal wound infection following open heart surgery: Appraisal of incidence, risk factors, changing bacteriologic pattern and treatment outcome

Background: The incidence of Sternal wound infection as reported worldwide is 0.43-2.3% [1-7]. The incidence is low and has serious effects on the patients in terms of the morbidity, hospital stay, cost as well as mortality. This study proposes to identify the risk factors, changing bacteriologic and the treatment outcomes. Methods: 6492 consecutive patients who had median sternotomy for open heart surgery in the adult unit were retrospectively analysed (using SPSS10. 0 window software) between July, 2005-August, 2010. 52 patients had Sternal wound infection 35patients were male and 17 female. The mean age was 57.4 ± SD 6.7 years. The number of diabetic patients was 40(76.9%) and hypertensive patients was 36(69. 2%). Sternal wound infection occurred in 52(0.8%) of the 6492. Results: The length of hospital stay was 23.5 days ± SD 8.9 days. The culture of swab or tissue was positive in 40 patients (81. 6%) and the microbiological culture yielded Pseudomonas aeruginosa in 17 patients (36.7%), staphylococcus species 11 (22.4%), streptococcus species 7(14.3%), Escherichiacoli 3(6.1%), Mycobacterium tuberculosis 2(4.1%), no growth 9(18.4%). Treatment outcome was good in 50(96%) patients and there was no in hospital mortality in 30 days. Conclusion: Sternal wound infection may occur due to non staphylococcus aureus organisms. Diabetes influenced the incidence of Sternal wound infection and aggressive surgical treatment led to good outcome. © 2011 Indian Association of Cardiovascular-Thoracic Surgeons.