Reining in Sternal Wound Infections: The Achilles' Heel of Bilateral Internal Thoracic Artery Grafting.

Aisha Zia, Marium Hasan, Sidra Ilyas, Hafiz Umair Siddiqui, Bassman Tappuni, Shayan Marsia, M Mujeeb Zubair, Sajjad Raza, Rami R Mustafa, Zulfiqar Qutrio Baloch, Salil V Deo, Umesh M Sharma, Mohammad Adil Sheikh

Journal: Surgical infections 2021;21(4):323-331

PMID: 31829828

Full Text on Atypon View on PubMed

Abstract

Although the survival advantage of bilateral internal thoracic artery grafting (BITA) is well known in patients undergoing coronary artery bypass grafting (CABG), this technique has not been widely adopted. This is mainly because of the increased risk of deep sternal wound infections (DSWI) associated with its use. However, in recent years the overall risk of DSWI has decreased. This is mainly because of strategies that have been adopted to decrease the risk of these infections in patients undergoing CABG. In this review we identified DSWI preventive strategies and described them in detail so that their use by surgeons can be increased. This would minimize the risk of DSWI after BITA grafting and maximize the use of this highly effective surgical technique.

Address: Department of Thoracic & Cardiovascular Surgery, Heart & Vascular Institute, Cleveland Clinic, Cleveland, Ohio, USA.; Department of Urology, The Kidney Centre, Karachi, Pakistan.; Department of Medicine, Detroit Medical Center/Wayne State University, Detroit, Michigan, USA.; Dow Medical College, Dow University of Health Sciences, Karachi, Pakistan.; Methodist DeBakey Heart & Vascular Center, Houston Methodist Hospital, Houston, Texas, USA.; University Hospitals Cleveland Medical Center, Cleveland, Ohio, USA.; Department of Medicine, Brandon Regional Hospital, Florida, USA.; Community Division of Hospital Medicine, Mayo Clinic Health System, Rochester, Minnesota, USA.

DOI: 10.1089/sur.2018.142

Link outs

Free resources

Medical:

https://medlineplus.gov/coronaryarterybypasssurger...

Subscription / membership required

Full Text Sources:

https://www.liebertpub.com/doi/10.1089/sur.2018.14...

MeSH Terms: Anti-Bacterial Agents, Blood Glucose, Body Mass Index, Carrier State, Chlorhexidine, Comorbidity, Coronary Artery Bypass, Humans, Infection Control, Length of Stay, Mammary Arteries, Mupirocin, Nutritional Status, Retrospective Studies, Risk Factors, Sex Factors, Sternum, Surgical Wound Infection