Related Experiment Video

Updated: May 2, 2026

Surgical Swine Model of Chronic Cardiac Ischemia Treated by Off-Pump Coronary Artery Bypass Graft Surgery
09:12

Surgical Swine Model of Chronic Cardiac Ischemia Treated by Off-Pump Coronary Artery Bypass Graft Surgery

Published on: March 27, 2018

9.0K

Toward zero: deep sternal wound infection after 1001 consecutive coronary artery bypass procedures using arterial

Teresa M Kieser1, M Sarah Rose2, Uthman Aluthman1

  • 1Departments of Cardiac Sciences and Surgery, Libin Cardiovascular Institute of Alberta, Calgary, Alberta, Canada.

The Journal of Thoracic and Cardiovascular Surgery
|March 12, 2014
PubMed

Insights

Implementing infection prevention measures significantly reduced deep sternal wound infections (DSWIs) after coronary artery bypass graft (CABG) surgery. Key strategies included chlorhexidine-alcohol skin preparation and avoiding bilateral internal thoracic artery (BITA) grafts in obese diabetic women.

Area of Science:

  • Cardiovascular Surgery
  • Infection Control
  • Surgical Outcomes

Background:

  • Coronary artery bypass graft (CABG) surgery using arterial conduits is optimal.
  • Deep sternal wound infection (DSWI) is a significant risk associated with bilateral internal thoracic artery (BITA) grafting.
  • Implementing infection prevention strategies is crucial for improving patient safety in CABG procedures.

Purpose of the Study:

  • To determine the significance of zero DSWIs in the latter part of a consecutive series of CABG operations.
  • To identify specific infection prevention measures responsible for reducing DSWIs.
  • To assess the impact of diabetes on DSWI rates following CABG surgery.

Main Methods:

  • Sequential implementation of 12 infection prevention measures, including internal thoracic artery (ITA) skeletonization, vancomycin paste, chlorhexidine-alcohol skin preparation, and avoiding BITA grafts in obese diabetic women.
  • Analysis of DSWI rates in 1001 consecutive CABG patients.
  • Statistical comparison of DSWI incidence before and after measure implementation.

Main Results:

  • DSWI rates decreased from 3% (16 of 532 patients) to 0% (0 of 469 patients) after implementing new measures (P<.001).
  • Chlorhexidine-alcohol skin preparation and avoiding BITA grafts in obese diabetic women were identified as key contributing factors.
  • Obese diabetic women had a significantly higher DSWI rate (21.4%) compared to other patients (2.0%), while other diabetic subgroups showed no increased risk.

Conclusions:

  • A comprehensive set of infection prevention measures led to a substantial reduction in DSWIs after CABG surgery.
  • The use of chlorhexidine-alcohol and selective avoidance of BITA grafting in obese diabetic females were critical for preventing DSWIs.
  • These strategies effectively minimized DSWI risk in most diabetic patients undergoing BITA grafting.
Abstract

More Related Videos

Author Spotlight: Enhancing Coronary Artery Revascularization05:25

Author Spotlight: Enhancing Coronary Artery Revascularization

Published on: September 15, 2023

1.5K
Full-root Aortic Valve Replacement by Stentless Aortic Xenografts in Patients with Small Aortic Roots12:17

Full-root Aortic Valve Replacement by Stentless Aortic Xenografts in Patients with Small Aortic Roots

Published on: May 21, 2017

10.5K

Related Concept Videos

Peripheral Artery Disease V: Postoperative Nursing Management01:23

Peripheral Artery Disease V: Postoperative Nursing Management

During the postoperative period, it is crucial to focus on maintaining circulation, identifying and managing potential complications, and planning for discharge.Nursing AssessmentVital signs monitoring: Regularly monitor vital signs, including blood pressure, heart rate, respiratory rate, and temperature, to detect early signs of complications such as bleeding and infection.Circulation assessment: Monitor pulses, perform Doppler assessments, and check capillary refill, color, temperature, and...
630
Diabetic Foot Ulcer01:31

Diabetic Foot Ulcer

Definition A diabetic foot ulcer (DFU) is a chronic, non-healing wound that develops in individuals with diabetes. It typically occurs on pressure-bearing areas such as the heel, metatarsal heads, or hallux, and carries a high risk of infection and amputation.Pathophysiology • The development of DFUs can be explained by four interconnected mechanisms: neuropathy, ischemia, infection, and impaired wound healing. • Neuropathy is the most common factor. Sensory...
33
Peripheral Artery Disease III: Interprofessional Care01:27

Peripheral Artery Disease III: Interprofessional Care

Peripheral Artery Disease (PAD) is characterized by narrowed arteries that diminish blood flow to the extremities. Effective management of PAD requires an interprofessional approach involving various healthcare professionals. The critical aspects of interprofessional care for PAD patients focus on risk factor modification, drug therapy, exercise therapy, nutrition therapy, critical limb ischemia care, and interventional radiology and surgical procedures.The primary treatment goal for PAD...
655