Protocol reduces sternal wound infections in children by 61 percent

A two-year effort to prevent infections in children healing from cardiac surgery reduced sternum infections by 61 percent, a San Antonio researcher announced at the Cardiology 2012 conference Feb. 23 in Orlando, Fla.

Faculty from UT Medicine San Antonio carried out a new infection-control protocol for 308 children who underwent sternotomies at CHRISTUS Santa Rosa Children's Hospital between 2009 and 2011. UT Medicine is the clinical practice of the School of Medicine at The University of Texas Health Science Center San Antonio.

Approach to children not standardized

A sternotomy is a surgical incision through the sternum. This particular study was the follow-up to an initial nationwide, multi-institutional study carried out by the group in 2009. The first study revealed that programs across the country had no standardized manner in which to prevent sternal (Annals of Thoracic Surgery 2011; 91:799-804). "This was noted to be of concern, as the adult cardiac surgical population has well-described protocols to prevent such infections," said S. Adil Husain, M.D., of UT Medicine San Antonio. He is associate professor of cardiothoracic surgery in the School of Medicine.

Multiple interventions implemented

The protocol tested in the follow-up study included preoperative baths with a skin disinfectant, the use of disposable, single-use electrodes, and administration of antibiotics no longer than an hour before the start of surgery. The number of sternal wound infections decreased from 14 the first year of the study to five the second year.

The sternum, also called the breastbone, anchors the rib cage protecting the heart and lungs. To correct , surgeons in many cases must break open the sternum to gain access to the operation site. More than 350 pediatric cardiac surgical cases are performed annually at the children's hospital with the sternum being opened at least 75 percent of the time.

Deep infections may involve areas around heart

"Sternal wound infection is relatively infrequent; however, when it occurs it increases the child's length of stay and recovery time," said Cathy Woodward, D.N.P., RN, PNP-AC, of UT Medicine and assistant professor of pediatrics in the School of . "The bone, muscle and tissue around the heart can become involved when the infection is deep."

Dr. Woodward presented the clinical findings in Orlando. The team also included Dr. Husain and critical care specialists Minnette Son, M.D., professor of pediatrics, and Richard Taylor, M.D., associate professor of pediatrics.

Multicenter study would be logical next step

Children from newborns to age 18 were included in the study. Using a protocol for children with delayed closure of the sternum also produced a lower infection rate, although it was not statistically significant.

"Because we had so few infections, we don't have enough statistical power to analyze these results," Dr. Woodward said. "This pilot finding lends itself to the need to do a multicenter study."

Provided by University of Texas Health Science Center at San Antonio

not rated yet
add to favorites email to friend print save as pdf

Related Stories

Biodegradable film reduces surgical scarring

Jan 29, 2008

A new, biodegradable film designed to reduce the severity of scarring following open heart surgery in young children appears to be safe and effective, according to researchers attending the annual meeting of the Society of ...

Pneumonia most common infection after heart surgery

Nov 15, 2011

Pneumonia — not a deep incision surgical site infection — is the most common serious infection after heart surgery, according to new research (Abstract 12247) presented at the American Heart Association's Scientific ...

Recommended for you

Overwhelmed west Africa ramps up Ebola response

4 hours ago

West Africa intensified its response to the deadly Ebola epidemic on Sunday, with Sierra Leone uncovering scores of dead bodies during a 72-hour shutdown and Liberia announcing hundreds of new hospital beds.

Sierra Leone reaches final day of Ebola lockdown

8 hours ago

Frustrated residents complained of food shortages in some neighborhoods of Sierra Leone's capital on Sunday as the country reached the third and final day of a sweeping, unprecedented lockdown designed to ...

Sierra Leone faces criticism over Ebola shutdown

Sep 20, 2014

Sierra Leone began the second day of a 72-hour nationwide shutdown aimed at containing the spread of the deadly Ebola virus on Saturday amid criticism that the action was a poorly planned publicity stunt.

Presence of peers ups health workers' hand hygiene

Sep 19, 2014

(HealthDay)—The presence of other health care workers improves hand hygiene adherence, according to a study published in the October issue of Infection Control and Hospital Epidemiology.

User comments