Deep Wound Infection in Pediatrics after Open Cardiac Surgery

AbstractSurgical site infection (SSI) is a serious complication requiring prolonged hospitalization, intravenous antibiotics, wound care and dressings resulting in increased cost and resistant bacteria. In pediatric cardiac surgery, Median sternotomy is the most frequently used incision for the correction of congenital anomalies. Sternal wound infections (SWIs) are well described complications of cardiac surgery and can occur in 3% to 8% of children. Furthermore, the mortality rate can increase 2-fold after SSIs. Also, SSIs are associated with an increased length of hospital stay, readmissions, and higher health care expenditures.Mediastinitis is a retrosternal wound infection frequently associated with a macroscopically sternal osteomyelitis. Mediastinitis is uncomfortable for patients, is poorly accepted by parents, leads to a prolonged hospital stay repeated surgery and prolonged antibiotic therapy. Mediastinitis are costly for patients, providers, and health-care institutions. In A recent survey among congenital heart programs, the incidence of mediastinitis has been reported to occur in 0.2 –1.4%. Gram-positive cocci are the most common pathogen. Gram negative organisms are increasingly recognized, especially in neonates, and are related to delayed sternal closure. Fungal organisms are not infrequently found.Mediastinitis generally presents 2–3 weeks after cardiac surgery. Child of ten appear irritable, tired, and febrile. The incision is erythematous and painful. Wo...
Source: QJM - Category: Internal Medicine Source Type: research