Advanced

Wound contamination in cardiac surgery

Kühme, Tobias LU ; Isaksson, Barbro and Dahlin, Lars LU (2007) In Acta Pathologica, Microbiologica et Immunologica Scandinavica (APMIS) 115(9). p.1001-1007
Abstract
Objectives: To investigate the degree of bacterial contamination in the sternal wound during cardiac surgery and the sternal skin flora after operation in order to increase our understanding of the pathogenesis of sternal wound infections. Design: Prospective study where cultures were taken peri- and postoperatively from sternal wounds and skin. Setting: University Hospital. Patients: 201 cardiac surgery patients. Results: 89% of the patients grew bacteria from the subcutaneous sternal tissue. 98% of the patients showed bacterial growth on the surrounding skin at the end of the operation. We found both commensal and nosocomial bacteria in the sternal wound. These bacteria had different temporal distribution patterns. Coagulase-negative... (More)
Objectives: To investigate the degree of bacterial contamination in the sternal wound during cardiac surgery and the sternal skin flora after operation in order to increase our understanding of the pathogenesis of sternal wound infections. Design: Prospective study where cultures were taken peri- and postoperatively from sternal wounds and skin. Setting: University Hospital. Patients: 201 cardiac surgery patients. Results: 89% of the patients grew bacteria from the subcutaneous sternal tissue. 98% of the patients showed bacterial growth on the surrounding skin at the end of the operation. We found both commensal and nosocomial bacteria in the sternal wound. These bacteria had different temporal distribution patterns. Coagulase-negative staphylococci (CoNS) and Propionibacterium acnes (PA) were by far the most prevalent bacteria during and after the operation. Furthermore, 41% of patients had more than 10 000 CFU/pad CoNS on the skin. There was no correlation between length of operation and number of bacteria. Men displayed higher bacterial counts than women on the skin. Conclusion: Skin preparation with ethanol/chlorhexidine is unable to suppress the physiological skin flora for the duration of a heart operation. A decrease of CoNS and PA postoperatively can be caused by competitive recolonisation of commensal and nosocomial bacteria. (Less)
Please use this url to cite or link to this publication:
author
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
infection, sternum, coagulase-negative staphylococci, Staphylococcus aureus, intraoperative recolonisation
in
Acta Pathologica, Microbiologica et Immunologica Scandinavica (APMIS)
volume
115
issue
9
pages
1001 - 1007
publisher
John Wiley & Sons
external identifiers
  • wos:000250144600004
  • scopus:35348854356
ISSN
1600-0463
DOI
10.1111/j.1600-0463.2007.00832.x
language
English
LU publication?
yes
id
5386a1cc-06b2-4448-9d6a-432aae39dbb3 (old id 907851)
date added to LUP
2008-01-09 15:05:32
date last changed
2017-04-02 03:36:34
@article{5386a1cc-06b2-4448-9d6a-432aae39dbb3,
  abstract     = {Objectives: To investigate the degree of bacterial contamination in the sternal wound during cardiac surgery and the sternal skin flora after operation in order to increase our understanding of the pathogenesis of sternal wound infections. Design: Prospective study where cultures were taken peri- and postoperatively from sternal wounds and skin. Setting: University Hospital. Patients: 201 cardiac surgery patients. Results: 89% of the patients grew bacteria from the subcutaneous sternal tissue. 98% of the patients showed bacterial growth on the surrounding skin at the end of the operation. We found both commensal and nosocomial bacteria in the sternal wound. These bacteria had different temporal distribution patterns. Coagulase-negative staphylococci (CoNS) and Propionibacterium acnes (PA) were by far the most prevalent bacteria during and after the operation. Furthermore, 41% of patients had more than 10 000 CFU/pad CoNS on the skin. There was no correlation between length of operation and number of bacteria. Men displayed higher bacterial counts than women on the skin. Conclusion: Skin preparation with ethanol/chlorhexidine is unable to suppress the physiological skin flora for the duration of a heart operation. A decrease of CoNS and PA postoperatively can be caused by competitive recolonisation of commensal and nosocomial bacteria.},
  author       = {Kühme, Tobias and Isaksson, Barbro and Dahlin, Lars},
  issn         = {1600-0463},
  keyword      = {infection,sternum,coagulase-negative staphylococci,Staphylococcus aureus,intraoperative recolonisation},
  language     = {eng},
  number       = {9},
  pages        = {1001--1007},
  publisher    = {John Wiley & Sons},
  series       = {Acta Pathologica, Microbiologica et Immunologica Scandinavica (APMIS)},
  title        = {Wound contamination in cardiac surgery},
  url          = {http://dx.doi.org/10.1111/j.1600-0463.2007.00832.x},
  volume       = {115},
  year         = {2007},
}