Suvorov Vitaliy V, Ivanov Dmitri O
Department of Surgical Diseases of Children, Saint-Petersburg State Pediatric Medical University, 194100 Saint Petersburg, Russia.
J Clin Med. 2024 Dec 19;13(24):7755. doi: 10.3390/jcm13247755.
This study was undertaken to determine the incidence and risk factors associated with the development of sternal wound infection in neonates after surgery for congenital heart disease. A case-control study was conducted to examine the influence of perioperative risk factors on the development of sternal infection. In total, 253 neonates with CHD underwent a complete median sternotomy. To identify the risk factors influencing the development of sternal infection, multivariable logistic regression analysis was used. Overall, 15 (5.9%) patients developed sternal wound infection after surgery. Deep wound infection occurred in six (2.4%) cases. As a result, the perioperative risk factors were the level of oxygen delivery in the postoperative period (OR: 0.956; CI: 0.933-0.98; < 0.001), duration of intubation after surgery (OR: 1.04; CI: 1.003-1.079; = 0.034) and application of surgical manipulation features (OR: 0.0004; CI: 0.000007-0.027; < 0.001). The incidence of sternal infection in newborns can be reduced by simple and affordable methods. This will decrease the cost of patient care, length of hospitalization and the risk of secondary complications.
本研究旨在确定先天性心脏病手术后新生儿胸骨伤口感染的发生率及相关危险因素。进行了一项病例对照研究，以检验围手术期危险因素对胸骨感染发生的影响。共有253例患有先天性心脏病的新生儿接受了完全正中胸骨切开术。为了确定影响胸骨感染发生的危险因素，采用了多变量逻辑回归分析。总体而言，15例（5.9%）患者术后发生了胸骨伤口感染。6例（2.4%）发生了深部伤口感染。结果显示，围手术期危险因素包括术后氧输送水平（比值比：0.956；可信区间：0.933 - 0.98；P < 0.001）、术后插管时间（比值比：1.04；可信区间：1.003 - 1.079；P = 0.034）和手术操作特点的应用（比值比：0.0004；可信区间：0.000007 - 0.027；P < 0.001）。通过简单且经济实惠的方法可以降低新生儿胸骨感染的发生率。这将降低患者护理成本、缩短住院时间并降低继发并发症的风险。
