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[Infection prophylaxis in cardiovascular surgery]

P L Vandone1, V Tolva, S Trimarchi

  • 1Istituto di Chirurgia Generale e Cardiovascolare, Ospedale Maggiore Policlinico, Università degli Studi, Milano.

Minerva Chirurgica
|October 22, 1998
PubMed
Summary

Improving surgical techniques and antibiotic prophylaxis significantly reduced cardiovascular surgical infections. This study highlights key strategies for preventing graft infections and sepsis in high-risk patients.

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Area of Science:

  • Cardiovascular Surgery
  • Infectious Disease Epidemiology
  • Vascular Grafting

Context:

  • Over 2950 patients with cardiovascular diseases underwent surgery between 1986-1994.
  • Vascular continuity was maintained with 2104 biological or synthetic grafts.
  • Abdominal aortic aneurysm repair was the most frequent procedure, with 783 emergency cases.

Purpose:

  • To analyze surgical infection incidence and trends in cardiovascular surgery patients.
  • To identify common infection types and risk factors, particularly for vascular graft infections.
  • To evaluate the effectiveness of antibiotic prophylaxis and treatment strategies.

Summary:

  • Surgical infection incidence decreased during the study period, with urinary tract infections being most common (38.5%).

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  • Vascular graft infections occurred in 14.4% of cases, with higher rates in aortobifemoral reconstructions.
  • Preoperative antibiotic prophylaxis with cephalosporins was standard; treatment involved antibiotics and/or surgery.

    • Impact:

    • Surgical technique refinement and appropriate antibiotic prophylaxis are crucial for reducing cardiovascular surgical infections.
    • Strategies to minimize sepsis and graft infection include optimized antibiotic therapy, reduced operative times, and careful patient selection.
    • Utilizing grafts with high biological compliance and minimizing invasive diagnostic procedures may further decrease infection risks.