Reining in Sternal Wound Infections: The Achilles' Heel of Bilateral Internal Thoracic Artery Grafting

Surg Infect (Larchmt). 2020 May;21(4):323-331. doi: 10.1089/sur.2018.142. Epub 2019 Dec 12.

Abstract

Background: Although the survival advantage of bilateral internal thoracic artery grafting (BITA) is well known in patients undergoing coronary artery bypass grafting (CABG), this technique has not been widely adopted. This is mainly because of the increased risk of deep sternal wound infections (DSWI) associated with its use. However, in recent years the overall risk of DSWI has decreased. This is mainly because of strategies that have been adopted to decrease the risk of these infections in patients undergoing CABG. Conclusion: In this review we identified DSWI preventive strategies and described them in detail so that their use by surgeons can be increased. This would minimize the risk of DSWI after BITA grafting and maximize the use of this highly effective surgical technique.

Keywords: CABG; bilateral ITA grafting; sternal wound infections.

Publication types

  • Review

MeSH terms

  • Anti-Bacterial Agents / administration & dosage
  • Blood Glucose
  • Body Mass Index
  • Carrier State / diagnosis
  • Carrier State / drug therapy
  • Chlorhexidine / administration & dosage
  • Comorbidity
  • Coronary Artery Bypass / adverse effects*
  • Coronary Artery Bypass / methods*
  • Humans
  • Infection Control / methods
  • Length of Stay
  • Mammary Arteries / surgery*
  • Mupirocin / administration & dosage
  • Nutritional Status
  • Retrospective Studies
  • Risk Factors
  • Sex Factors
  • Sternum / surgery*
  • Surgical Wound Infection / epidemiology*

Substances

  • Anti-Bacterial Agents
  • Blood Glucose
  • Mupirocin
  • Chlorhexidine