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Risk Factors for Surgical Site Infection After Cardiac Surgery in Neonates: A Case-Control Study
Vitaliy V Suvorov1, Dmitri O Ivanov1
1Department of Surgical Diseases of Children, Saint-Petersburg State Pediatric Medical University, 194100 Saint Petersburg, Russia.
Journal of Clinical Medicine
|January 8, 2025
Summary
Sternal wound infections occur in 5.9% of neonates after congenital heart disease surgery. Postoperative oxygen levels and intubation duration are key risk factors for these infections.
Area of Science:
- Pediatric Surgery
- Neonatal Care
- Infectious Disease Epidemiology
Background:
- Congenital heart disease (CHD) necessitates surgical intervention in neonates.
- Sternal wound infection (SWI) is a significant postoperative complication following median sternotomy for CHD.
- Understanding SWI incidence and risk factors is crucial for improving neonatal surgical outcomes.
Purpose of the Study:
- To determine the incidence of sternal wound infection in neonates undergoing surgery for congenital heart disease.
- To identify perioperative risk factors associated with the development of sternal wound infection.
- To inform strategies for reducing SWI in this vulnerable population.
Main Methods:
- A case-control study design was employed.
- Data were collected from 253 neonates who underwent complete median sternotomy for CHD.
- Multivariable logistic regression analysis was used to identify risk factors for sternal infection.
Main Results:
- The overall incidence of sternal wound infection was 5.9% (15/253 neonates).
- Deep wound infection occurred in 2.4% (6/253) of cases.
- Significant perioperative risk factors included postoperative oxygen delivery levels (OR: 0.956), duration of intubation (OR: 1.04), and surgical manipulation features (OR: 0.0004).
Conclusions:
- The incidence of sternal infection in neonates post-CHD surgery is substantial.
- Simple, cost-effective methods can potentially reduce SWI rates.
- Reducing SWI can decrease healthcare costs, shorten hospital stays, and mitigate secondary complications.
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