[Risk factors and therapeutic methods for sternal wound infection following cardiac surgery]

In a study of 1040 patients undergoing cardiac surgery at The Osaka Medical College Hospital from 1984 through 1991, we analyzed the correlation between a variety of preoperative and operative parameters and the risk of postoperative sternal wound infection, as well as the efficacy of various therapeutic method for this condition. Sternal infection or mediastinitis developed after cardiac surgery in 31 patients (3.0%). As the risk factors for wound infections, age, diabetes mellitus, reexploration, duration of cardiopulmonary bypass and use of bilateral internal thoracic artery grafting were listed. Application of pectoral muscle flaps significantly led to shorten a duration between diagnosis of infection and hospital discharge, and increased survival rate, than the other treating methods such as debridement or irrigation. We conclude that bilateral internal thoracic artery grafts should not be used in the cases with diabetes, and closure with pectoral muscle flaps is effective for sternal infection and mediastinitis.