Surgical Site Infections in Cardiac Surgery, Open-Heart Surgery Infections

Abstract

Relevance. Cardiac surgery is a direction that is currently being actively developed. The number of operations performed on an openheart is growing annually, and the number of postoperative complications, including infectious ones, is correspondingly increasing. The purpose of the work is to identify the frequency of surgical site infections (SSI) in open-heart surgery, to study the leading risk factors, to identify possible sources of infection. Materials and methods. Basic information was obtained from medical records, as well as using the medical information system, which allows to track the patient's repeated hospitalization in the hospital, and the laboratory information system. Additional forms have been developed to account for intraoperative risk factors. The follow-up period was 3 years (2016-2018). A total of 433 surgical interventions and their outcomes were analyzed, the duration of follow-up f o r patients was 1 year from the time of surgery. Identified 19 cases of SSI. Results and discussion. The frequency of SSI in open-heart surgery was 4.4 per 100 operations (2.6-6.7). Up to 74% of all SSI occurred in the period up to 30 days from the moment of surgery. The relative risk index was calculated for such factors as the length of stay in the intensive care unit in the postoperative period, the timing of drainage of the postoperative wound, and diabetes mellitus. It has been established that for cardiosurgical operations on the 1st class of wounds, diabetes mellitus is a significant risk factor for SSI. The analysis pathogens in patients with acute respiratory infections and the microbiological landscape of the departments made it possible to establish cases of possible infection of patients in the hospital, and in some cases put forward an assumption of endogenous infection. Conclusions. An epidemiological investigation, the development, and implementation of anti-epidemic measures require a complete consideration of possible risk factors, the participation of cardiac surgeons in identifying, and analyzing each case of SSI, and the mandatory exchange of information about the outcome of the disease between medical organizations that are involved in the management of a cardiac surgical patient in the postoperative period.

Keywords

• surgical site infections in cardiac surgery
• open-heart surgery infections