Outcomes following the implementation of a quality control campaign to decrease sternal wound infections after...

Area of Science:

• Cardiothoracic Surgery
• Infectious Disease Prevention
• Patient Safety

Background:

• Coronary artery by-pass grafting (CABG) is optimal for complex coronary artery disease but carries risks of sternal wound infections (SWI).
• Uppsala University Hospital observed a rise in SWI, peaking in 2009, necessitating a review of surgical processes.
• Post-operative infection monitoring involved patient questionnaires regarding wound infection treatments.

Purpose of the Study:

• To evaluate the effectiveness of an intervention program aimed at reducing sternal wound infections (SWI) following coronary artery by-pass grafting (CABG).
• To determine if changes in patient population characteristics influenced SWI rates post-intervention.

Main Methods:

• A retrospective study included patients undergoing isolated CABG between 2006 and 2012.
• Data from 1515 patients (92.3% response rate) were analyzed, comparing the pre-intervention (2006-early 2010) and post-intervention (early 2010-2012) periods.
• Medical records were reviewed to assess risk factors and rule out changes in patient demographics as the cause for SWI frequency changes.

Main Results:

• A significant decrease in the frequency of sternal wound infections (SWI) was observed following the implementation of the intervention program.
• The reduction in SWI was not attributable to improvements in the overall health status of the patient population.

Conclusions:

• The implemented intervention program positively impacted patient outcomes by reducing the incidence of SWI after CABG.
• Due to simultaneous changes in perioperative care, the specific component most effective in reducing SWI could not be isolated.