Steingrímsson Steinn, Sjögren Johan, Gudbjartsson Tomas
Department of Cardiothoracic Surgery, Landspitali University Hospital, Reykjavik, Iceland.
Scand J Infect Dis. 2012 Aug;44(8):623-5. doi: 10.3109/00365548.2012.669842. Epub 2012 Apr 12.
We studied the incidence and characteristics of surgically treated sternocutaneous fistulas in a nationwide cohort of patients undergoing open heart surgery in Iceland. Between 2000 and 2010, sternocutaneous fistulas were treated surgically in 6 out of 2446 patients undergoing open heart surgery (incidence 0.25%, 95% confidence interval 0.11-0.53%). All patients were male, with a mean age of 71 ± 9 y. In addition to antibiotic treatment, debridement of the wound was performed in all cases. Staphylococcus aureus and/or coagulase-negative staphylococci were identified as pathogens in 5 cases and Candida albicans in 1. Chronic infections developed in 3 patients who were treated repeatedly, 1 of them unsuccessfully. In-hospital stay ranged from 0 to 50 days (mean 19 days). Sternocutaneous fistulas are rare, but since they may have a devastating course, increased awareness of this infectious complication of open heart surgery is important.
我们在冰岛全国范围内接受心脏直视手术的患者队列中研究了手术治疗的胸骨皮肤瘘的发生率和特征。2000年至2010年期间，2446例接受心脏直视手术的患者中有6例接受了胸骨皮肤瘘手术治疗（发生率0.25%，95%置信区间0.11 - 0.53%）。所有患者均为男性，平均年龄71±9岁。除抗生素治疗外，所有病例均进行了伤口清创。5例患者的病原体鉴定为金黄色葡萄球菌和/或凝固酶阴性葡萄球菌，1例为白色念珠菌。3例反复接受治疗的患者发生了慢性感染，其中1例治疗失败。住院时间为0至50天（平均19天）。胸骨皮肤瘘很罕见，但由于其病程可能很严重，提高对心脏直视手术这种感染性并发症的认识很重要。
