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Impact of delayed sternal closure on wound infections following neonatal and infant cardiac surgery

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Impact of delayed sternal closure on wound infections following neonatal and infant cardiac surgery. / von Stumm, Maria; Leps, Yola; Jochheim, Luca; van Rüth, Victoria; Gottschalk, Urda; Mueller, Goetz; Kozlik-Feldmann, Rainer; Hazekamp, Mark G; Sachweh, Joerg S; Biermann, Daniel.

In: PLOS ONE, Vol. 17, No. 5, e0267985, 2022.

Research output: SCORING: Contribution to journal › SCORING: Journal article › Research › peer-review

Harvard

von Stumm, M, Leps, Y, Jochheim, L, van Rüth, V, Gottschalk, U, Mueller, G, Kozlik-Feldmann, R, Hazekamp, MG, Sachweh, JS & Biermann, D 2022, 'Impact of delayed sternal closure on wound infections following neonatal and infant cardiac surgery', PLOS ONE, vol. 17, no. 5, e0267985. https://doi.org/10.1371/journal.pone.0267985

APA

von Stumm, M., Leps, Y., Jochheim, L., van Rüth, V., Gottschalk, U., Mueller, G., Kozlik-Feldmann, R., Hazekamp, M. G., Sachweh, J. S., & Biermann, D. (2022). Impact of delayed sternal closure on wound infections following neonatal and infant cardiac surgery. PLOS ONE, 17(5), [e0267985]. https://doi.org/10.1371/journal.pone.0267985

Vancouver

von Stumm M, Leps Y, Jochheim L, van Rüth V, Gottschalk U, Mueller G et al. Impact of delayed sternal closure on wound infections following neonatal and infant cardiac surgery. PLOS ONE. 2022;17(5). e0267985. https://doi.org/10.1371/journal.pone.0267985

Bibtex

@article{9789e4688ba34405ac3f726a202686ac,
title = "Impact of delayed sternal closure on wound infections following neonatal and infant cardiac surgery",
abstract = "OBJECTIVES: Delayed sternal closure is a routine procedure to reduce hemodynamic and respiratory instability in pediatric patients following cardiac surgery, particularly in neonates and infants. In this setting, the possible links between sternal wound infection and delayed sternal closure are still a matter of debate. As a part of our routine, there was a low threshold for delayed sternal closure, so we reviewed our experience with sternal wound infections with a focus on potentially related perioperative risk factors, particularly delayed sternal closure.METHODS: We retrospectively identified 358 operated neonates (37%) and infants (mean age 3.6 months) in our local congenital heart disease database between January 2013 and June 2017. Potential risk factors for sternal wound infections, such as age, gender, complexity (based on Aristotle- and STS-EACTS mortality category), reoperation, use of cardiopulmonary bypass, extracorporeal membrane oxygenation, mortality and delayed sternal closure (163/358, 46%), were subjected to uni- and multivariate analysis.RESULTS: A total of 26/358 patients (7.3%) developed a superficial sternal wound infection. There were no deep sternal wound infections, no mediastinitis or sepsis. Applying univariate analysis, the prevalence of sternal wound infections was related to younger age, more complex surgery and delayed sternal closure. However, in multivariate analysis, sternal wound infection was only associated with delayed sternal closure (p = 0.013, odds ratio 8.6). Logistic regression revealed the prevalence of delayed sternal closure to be related to younger age, complexity, and the use of extracorporeal membrane oxygenation.CONCLUSION: In patients younger than one year, sternal wound infections are clearly related to delayed sternal closure. However, in our cohort, all sternal wound infections were superficial and acceptable, considering the improved postoperative hemodynamic stability.",
keywords = "Cardiac Surgical Procedures/methods, Child, Humans, Infant, Infant, Newborn, Retrospective Studies, Sternum/surgery, Surgical Wound Infection/etiology, Time Factors, Treatment Outcome, Wound Infection/etiology",
author = "{von Stumm}, Maria and Yola Leps and Luca Jochheim and {van R{\"u}th}, Victoria and Urda Gottschalk and Goetz Mueller and Rainer Kozlik-Feldmann and Hazekamp, {Mark G} and Sachweh, {Joerg S} and Daniel Biermann",
year = "2022",
doi = "10.1371/journal.pone.0267985",
language = "English",
volume = "17",
journal = "PLOS ONE",
issn = "1932-6203",
publisher = "Public Library of Science",
number = "5",

}

RIS

TY - JOUR

T1 - Impact of delayed sternal closure on wound infections following neonatal and infant cardiac surgery

AU - von Stumm, Maria

AU - Leps, Yola

AU - Jochheim, Luca

AU - van Rüth, Victoria

AU - Gottschalk, Urda

AU - Mueller, Goetz

AU - Kozlik-Feldmann, Rainer

AU - Hazekamp, Mark G

AU - Sachweh, Joerg S

AU - Biermann, Daniel

PY - 2022

Y1 - 2022

N2 - OBJECTIVES: Delayed sternal closure is a routine procedure to reduce hemodynamic and respiratory instability in pediatric patients following cardiac surgery, particularly in neonates and infants. In this setting, the possible links between sternal wound infection and delayed sternal closure are still a matter of debate. As a part of our routine, there was a low threshold for delayed sternal closure, so we reviewed our experience with sternal wound infections with a focus on potentially related perioperative risk factors, particularly delayed sternal closure.METHODS: We retrospectively identified 358 operated neonates (37%) and infants (mean age 3.6 months) in our local congenital heart disease database between January 2013 and June 2017. Potential risk factors for sternal wound infections, such as age, gender, complexity (based on Aristotle- and STS-EACTS mortality category), reoperation, use of cardiopulmonary bypass, extracorporeal membrane oxygenation, mortality and delayed sternal closure (163/358, 46%), were subjected to uni- and multivariate analysis.RESULTS: A total of 26/358 patients (7.3%) developed a superficial sternal wound infection. There were no deep sternal wound infections, no mediastinitis or sepsis. Applying univariate analysis, the prevalence of sternal wound infections was related to younger age, more complex surgery and delayed sternal closure. However, in multivariate analysis, sternal wound infection was only associated with delayed sternal closure (p = 0.013, odds ratio 8.6). Logistic regression revealed the prevalence of delayed sternal closure to be related to younger age, complexity, and the use of extracorporeal membrane oxygenation.CONCLUSION: In patients younger than one year, sternal wound infections are clearly related to delayed sternal closure. However, in our cohort, all sternal wound infections were superficial and acceptable, considering the improved postoperative hemodynamic stability.

AB - OBJECTIVES: Delayed sternal closure is a routine procedure to reduce hemodynamic and respiratory instability in pediatric patients following cardiac surgery, particularly in neonates and infants. In this setting, the possible links between sternal wound infection and delayed sternal closure are still a matter of debate. As a part of our routine, there was a low threshold for delayed sternal closure, so we reviewed our experience with sternal wound infections with a focus on potentially related perioperative risk factors, particularly delayed sternal closure.METHODS: We retrospectively identified 358 operated neonates (37%) and infants (mean age 3.6 months) in our local congenital heart disease database between January 2013 and June 2017. Potential risk factors for sternal wound infections, such as age, gender, complexity (based on Aristotle- and STS-EACTS mortality category), reoperation, use of cardiopulmonary bypass, extracorporeal membrane oxygenation, mortality and delayed sternal closure (163/358, 46%), were subjected to uni- and multivariate analysis.RESULTS: A total of 26/358 patients (7.3%) developed a superficial sternal wound infection. There were no deep sternal wound infections, no mediastinitis or sepsis. Applying univariate analysis, the prevalence of sternal wound infections was related to younger age, more complex surgery and delayed sternal closure. However, in multivariate analysis, sternal wound infection was only associated with delayed sternal closure (p = 0.013, odds ratio 8.6). Logistic regression revealed the prevalence of delayed sternal closure to be related to younger age, complexity, and the use of extracorporeal membrane oxygenation.CONCLUSION: In patients younger than one year, sternal wound infections are clearly related to delayed sternal closure. However, in our cohort, all sternal wound infections were superficial and acceptable, considering the improved postoperative hemodynamic stability.

KW - Cardiac Surgical Procedures/methods

KW - Child

KW - Humans

KW - Infant

KW - Infant, Newborn

KW - Retrospective Studies

KW - Sternum/surgery

KW - Surgical Wound Infection/etiology

KW - Time Factors

KW - Treatment Outcome

KW - Wound Infection/etiology

U2 - 10.1371/journal.pone.0267985

DO - 10.1371/journal.pone.0267985

M3 - SCORING: Journal article

C2 - 35604953

VL - 17

JO - PLOS ONE

JF - PLOS ONE

SN - 1932-6203

IS - 5

M1 - e0267985

ER -