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Infection control in cardiac surgery.

R E Clark, W C Amos, V Higgins

    Surgery
    |January 1, 1976
    PubMed
    Summary
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    Implementing a comprehensive infection control program significantly reduced surgical site infections in cardiac surgery patients. Key interventions included improved operating room ventilation and enhanced barrier precautions, leading to lower deep wound and prosthetic valve infection rates.

    Area of Science:

    • Infection Control
    • Cardiac Surgery
    • Hospital Epidemiology

    Background:

    • Cardiac operations and extracorporeal circulation carry a risk of superficial and deep wound infections, as well as prosthetic valve infections.
    • Previous infection rates in cardiac surgery patients were analyzed retrospectively (1966-1970).

    Purpose of the Study:

    • To evaluate the effectiveness of a multifaceted infection reduction program implemented between 1970 and 1974.
    • To decrease the incidence of surgical site infections in patients undergoing cardiac operations.

    Main Methods:

    • A prospective study was conducted following the implementation of a comprehensive infection control program.
    • Interventions included operating room renovation with unidirectional ventilation, improved gown and draping materials, frequent prosthetic valve sterilization, routine antibiotic prophylaxis, and bacteriologic monitoring of personnel.

    Related Experiment Videos

  • Studies also assessed airborne particulates, bacteria, skin preparation, and hair removal practices.

    • Main Results:

    • The high-flow HEPA filtered ventilation system and altered operating room clothing reduced airborne particles and wound bacteria by a factor of 10.
    • Markedly contaminated hands decreased, and shedders/carriers were identified.
    • Deep wound infection rates decreased from 2.9% to 0.6% (p<0.01), total wound infections from 6.6% to 3.3%, and prosthetic valve infections from 5.6% to 1.4%.

    Conclusions:

    • A multifaceted infection control program addressing both endogenous and exogenous sources is effective in reducing infection rates in cardiac surgical patients.
    • Improvements in operating room environment and barrier techniques significantly lowered infection incidence.
    • Attention to patient-specific factors and environmental controls is crucial for preventing infections post-cardiac surgery.