Follow-up and intensive care preoperative and intraoperative risk factors of surgical wound infection in cardiac surgery: a retrospective study

Objective: To assess the significance of preoperative and intraoperative risk factors of surgical wound infection in cardiac surgery. Methods: The retrospective study included data obtained from 1,992 medical records of patients after cardiac surgery. All patients were divided into two groups: with (n=97, 4.9%) or without (n=1,895, 95.1%) infectious complications in the postoperative period. The rate of risk factors in both groups was compared and their impact on the surgical wound infection was assessed. Risk factors were analyzed in the groups of patients with superficial and deep forms of infection. Results: In the group of patients with surgical wound infection, males are more common than among the patients without it (82.5% vs. 70.95%). Patients with infection were more likely to have an obesity (43.3% vs. 30.3% without surgical wound infection) and chronic obstructive pulmonary disease (24.7% vs. 13.3%, respectively). In the patients with surgical wound infection, two internal mammary arteries were used more often (29.9% vs. 17.3% without surgical wound infection), the crossover variant of using two internal mammary arteries - 55.2% vs. 34.1% without surgical wound infection. According to the results, male gender and chronic obstructive pulmonary disease increase the risk of surgical wound infection twice as much, with obesity increasing this risk by 1.76 times. Using one of the internal mammary arteries may increase the chances of surgical wound infection by 1.7 times, while using two arteries - by 3.27 times. Increasing the number of factors in one patient may increase the chances of complications by 1.31 times. Conclusion: In cardiac surgery one should assess risk factors of surgical wound infection, plan the surgery (with or without internal mammary arteries), and evaluate the probability of infection complications with personalized approach.