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Eur J Cardiothorac Surg 2003;23:97-102
© 2003 Elsevier Science NL
a Department of Medical Microbiology, University Hospital Maastricht, Maastricht, The Netherlands
b Department of Cardiothoracic Surgery, University Hospital Maastricht, Maastricht, The Netherlands
c Department of Clinical Epidemiology, University Hospital Maastricht, Maastricht, The Netherlands
Received 4 June 2002; received in revised form 12 September 2002; accepted 1 October 2002.
* Corresponding author. Tel.: +31-43-387-4644; fax: +31-43-387-6643
e-mail: est{at}lmib.azm.nl
Objective: Postoperative wound infections generally cause considerable extra morbidity, mortality and costs. As nowadays length of hospitalization shortens, post-discharge surveillance is important to get reliable information on the prevalence of postoperative wound infections. In this study, the prevalences of sternal wound (SWI) and donor site infections (DSI) during hospitalization as well as, 30 and 90 days after cardiac surgery were studied paying special attention to the contribution of post-discharge surveillance. Methods: A total of 1885 patients who underwent cardiac surgery were included in the study and were followed for the prevalence of SWI or DSI up to 90 days postoperatively. Infection data during hospitalization were collected using medical records, bacteriological results and systematic observations of infection control nurses. After discharge from the hospital, data were collected with the help of the out-patient clinic and the family physician. Results: After cardiac surgery, SWI and DSI were diagnosed in 4.7 and 1.5% of patients during hospitalization, in 6.8 and 4.6% at 30 days postoperatively, and in 9.0 and 7.3% of patients at 90 days postoperatively. Of the 90-days postoperative infections rates almost half of SWI and 80% of DSI were diagnosed post-discharge, a result predominantly achieved by the active participation of the family physicians. Conclusions: After 30 and 90 days follow-up of patients after cardiac surgery, additional sternal wound and donor site infections were diagnosed compared with the in-hospital infection rate. Post-discharge surveillance is essential for a reliable assessment of surgical wound infections.
Key Words: Cardiac surgery • Sternal wound infection • Donor site infection • Post-discharge surveillance
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