Loading…

Efficiency of an algorithm for the prevention of sternal infection after cardiac surgery in children under 1 year of age: A single-center retrospective study

Sternal infection is one of the most challenging complications to manage after heart surgery. The aim of our study is to evaluate the effectiveness of a developed algorithm for preventing sternal infection in pediatric patients after surgery for congenital heart disease (CHD). We conducted a single-...

Full description

Saved in:
Bibliographic Details
Published in:Heliyon 2024-05, Vol.10 (9), p.e29991-e29991, Article e29991
Main Authors: Suvorov, V.V., Zaitsev, V.V., Gvozd, E.M.
Format: Article
Language:English
Subjects:
Citations: Items that this one cites
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
cited_by
cites cdi_FETCH-LOGICAL-c482t-5614ce0adc3436b8140ef496a6095819d5731acfc7a6a435591b9f4a4d166df13
container_end_page e29991
container_issue 9
container_start_page e29991
container_title Heliyon
container_volume 10
creator Suvorov, V.V.
Zaitsev, V.V.
Gvozd, E.M.
description Sternal infection is one of the most challenging complications to manage after heart surgery. The aim of our study is to evaluate the effectiveness of a developed algorithm for preventing sternal infection in pediatric patients after surgery for congenital heart disease (CHD). We conducted a single-center study examining the treatment of 478 children with CHD. Patients were divided into 2 groups, taking into account the application of a developed management algorithm. A multivariate logistic regression analysis was used to identify the factors influencing the development of sternal infection following heart surgery using median sternotomy. A developed algorithm was applied in 308 children. In total, there were 16 cases of sternal infection (3.34 %) across both groups. Deep wound infection developed in 6 patients (1.26 %). Sternal infection developed in 2 children (0.65 %) in the first group (in which the algorithm was applied) and 14 children (8.2 %) in the second group. Deep sternal infection developed in 1 patient in the first group (0.33 %) and in 5 patients in the second group (2.94 %). As a result, perioperative risk factors as postoperative resternotomy (OR 23.315; p 
doi_str_mv 10.1016/j.heliyon.2024.e29991
format article
fullrecord <record><control><sourceid>proquest_doaj_</sourceid><recordid>TN_cdi_doaj_primary_oai_doaj_org_article_9e1ecfd948384a5f8fae967dd0607518</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><els_id>S2405844024060225</els_id><doaj_id>oai_doaj_org_article_9e1ecfd948384a5f8fae967dd0607518</doaj_id><sourcerecordid>3050174231</sourcerecordid><originalsourceid>FETCH-LOGICAL-c482t-5614ce0adc3436b8140ef496a6095819d5731acfc7a6a435591b9f4a4d166df13</originalsourceid><addsrcrecordid>eNqFkstu1DAUhiMEolXpI4C8ZJPBTmzHZoOqqkClSmxgbXns44xHGXuwk5HyMH1XnJmhtCtWPjqX71z8V9V7glcEE_5pu9rA4OcYVg1u6AoaKSV5VV02FLNaUIpfP7MvquuctxhjwgSXXfu2umiLQXHXXVaPd8554yGYGUWHdEB66GPy42aHXExo3ADaJzhAGH0MS0oeIQU9IB8cmKNTu-JCRifrtUF5Sj2kucSR2fjBJghoCrZkEDSDTsc2PXxGNyj70A9QmwIv4QRjinm_QA9Q2kx2fle9cXrIcH1-r6pfX-9-3n6vH358u7-9eagNFc1YM06oAaytaWnL14JQDI5KrjmWTBBpWdcSbZzpNNe0ZUyStXRUU0s4t460V9X9iWuj3qp98judZhW1V0dHTL3SafRmACWBgHFWUtEKqpkTToPknbWY444RUVhfTqz9tN6BXZZLengBfRkJfqP6eFCEYCaEZIXw8UxI8fcEeVQ7nw0Mgw4Qp6xazDDpaNMug7NTqimnywncUx-C1SIVtVVnqahFKuoklVL34fmQT1V_hfFvCyhnP3hIKh9VAtan8kPlLv4_Lf4AYejWMg</addsrcrecordid><sourcetype>Open Website</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>3050174231</pqid></control><display><type>article</type><title>Efficiency of an algorithm for the prevention of sternal infection after cardiac surgery in children under 1 year of age: A single-center retrospective study</title><source>ScienceDirect Journals</source><source>PubMed Central</source><creator>Suvorov, V.V. ; Zaitsev, V.V. ; Gvozd, E.M.</creator><creatorcontrib>Suvorov, V.V. ; Zaitsev, V.V. ; Gvozd, E.M.</creatorcontrib><description>Sternal infection is one of the most challenging complications to manage after heart surgery. The aim of our study is to evaluate the effectiveness of a developed algorithm for preventing sternal infection in pediatric patients after surgery for congenital heart disease (CHD). We conducted a single-center study examining the treatment of 478 children with CHD. Patients were divided into 2 groups, taking into account the application of a developed management algorithm. A multivariate logistic regression analysis was used to identify the factors influencing the development of sternal infection following heart surgery using median sternotomy. A developed algorithm was applied in 308 children. In total, there were 16 cases of sternal infection (3.34 %) across both groups. Deep wound infection developed in 6 patients (1.26 %). Sternal infection developed in 2 children (0.65 %) in the first group (in which the algorithm was applied) and 14 children (8.2 %) in the second group. Deep sternal infection developed in 1 patient in the first group (0.33 %) and in 5 patients in the second group (2.94 %). As a result, perioperative risk factors as postoperative resternotomy (OR 23.315; p &lt; 0.001), delayed sternal closure (OR 9.087; p = 0.003), development of acute renal failure (OR 5.322; p = 0.018) were associated with increased risk of infection and application of the developed algorithm resulted in a significant reduction in risk (OR 0.032; p &lt; 0.001). The suggested method for the prevention of sternal infection has significantly reduced the incidence of sternal infection after cardiac surgery in children less than 1 year of age. In patients with moderate to high risk for surgical site infection, surgeons can enhance wound healing and prevent wound infections with simple, inexpensive, and readily available tools and techniques. Surgical aspects, topical use of antibiotics, prevention of peripheral vasoconstriction, maintenance of normal oxygen delivery rates, and an individual approach to intensive care are essential.</description><identifier>ISSN: 2405-8440</identifier><identifier>EISSN: 2405-8440</identifier><identifier>DOI: 10.1016/j.heliyon.2024.e29991</identifier><identifier>PMID: 38694077</identifier><language>eng</language><publisher>England: Elsevier Ltd</publisher><subject>Complication in pediatric cardiac surgery ; Infection in pediatric cardiac surgery ; Mediastinitis ; Sternal infection ; Sternal instability ; Wound infection in pediatric</subject><ispartof>Heliyon, 2024-05, Vol.10 (9), p.e29991-e29991, Article e29991</ispartof><rights>2024 The Authors</rights><rights>2024 The Authors.</rights><rights>2024 The Authors 2024</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c482t-5614ce0adc3436b8140ef496a6095819d5731acfc7a6a435591b9f4a4d166df13</cites><orcidid>0000-0002-4683-1454</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC11058895/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.sciencedirect.com/science/article/pii/S2405844024060225$$EHTML$$P50$$Gelsevier$$Hfree_for_read</linktohtml><link.rule.ids>230,314,727,780,784,885,3549,27924,27925,45780,53791,53793</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/38694077$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Suvorov, V.V.</creatorcontrib><creatorcontrib>Zaitsev, V.V.</creatorcontrib><creatorcontrib>Gvozd, E.M.</creatorcontrib><title>Efficiency of an algorithm for the prevention of sternal infection after cardiac surgery in children under 1 year of age: A single-center retrospective study</title><title>Heliyon</title><addtitle>Heliyon</addtitle><description>Sternal infection is one of the most challenging complications to manage after heart surgery. The aim of our study is to evaluate the effectiveness of a developed algorithm for preventing sternal infection in pediatric patients after surgery for congenital heart disease (CHD). We conducted a single-center study examining the treatment of 478 children with CHD. Patients were divided into 2 groups, taking into account the application of a developed management algorithm. A multivariate logistic regression analysis was used to identify the factors influencing the development of sternal infection following heart surgery using median sternotomy. A developed algorithm was applied in 308 children. In total, there were 16 cases of sternal infection (3.34 %) across both groups. Deep wound infection developed in 6 patients (1.26 %). Sternal infection developed in 2 children (0.65 %) in the first group (in which the algorithm was applied) and 14 children (8.2 %) in the second group. Deep sternal infection developed in 1 patient in the first group (0.33 %) and in 5 patients in the second group (2.94 %). As a result, perioperative risk factors as postoperative resternotomy (OR 23.315; p &lt; 0.001), delayed sternal closure (OR 9.087; p = 0.003), development of acute renal failure (OR 5.322; p = 0.018) were associated with increased risk of infection and application of the developed algorithm resulted in a significant reduction in risk (OR 0.032; p &lt; 0.001). The suggested method for the prevention of sternal infection has significantly reduced the incidence of sternal infection after cardiac surgery in children less than 1 year of age. In patients with moderate to high risk for surgical site infection, surgeons can enhance wound healing and prevent wound infections with simple, inexpensive, and readily available tools and techniques. Surgical aspects, topical use of antibiotics, prevention of peripheral vasoconstriction, maintenance of normal oxygen delivery rates, and an individual approach to intensive care are essential.</description><subject>Complication in pediatric cardiac surgery</subject><subject>Infection in pediatric cardiac surgery</subject><subject>Mediastinitis</subject><subject>Sternal infection</subject><subject>Sternal instability</subject><subject>Wound infection in pediatric</subject><issn>2405-8440</issn><issn>2405-8440</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2024</creationdate><recordtype>article</recordtype><sourceid>DOA</sourceid><recordid>eNqFkstu1DAUhiMEolXpI4C8ZJPBTmzHZoOqqkClSmxgbXns44xHGXuwk5HyMH1XnJmhtCtWPjqX71z8V9V7glcEE_5pu9rA4OcYVg1u6AoaKSV5VV02FLNaUIpfP7MvquuctxhjwgSXXfu2umiLQXHXXVaPd8554yGYGUWHdEB66GPy42aHXExo3ADaJzhAGH0MS0oeIQU9IB8cmKNTu-JCRifrtUF5Sj2kucSR2fjBJghoCrZkEDSDTsc2PXxGNyj70A9QmwIv4QRjinm_QA9Q2kx2fle9cXrIcH1-r6pfX-9-3n6vH358u7-9eagNFc1YM06oAaytaWnL14JQDI5KrjmWTBBpWdcSbZzpNNe0ZUyStXRUU0s4t460V9X9iWuj3qp98judZhW1V0dHTL3SafRmACWBgHFWUtEKqpkTToPknbWY444RUVhfTqz9tN6BXZZLengBfRkJfqP6eFCEYCaEZIXw8UxI8fcEeVQ7nw0Mgw4Qp6xazDDpaNMug7NTqimnywncUx-C1SIVtVVnqahFKuoklVL34fmQT1V_hfFvCyhnP3hIKh9VAtan8kPlLv4_Lf4AYejWMg</recordid><startdate>20240515</startdate><enddate>20240515</enddate><creator>Suvorov, V.V.</creator><creator>Zaitsev, V.V.</creator><creator>Gvozd, E.M.</creator><general>Elsevier Ltd</general><general>Elsevier</general><scope>6I.</scope><scope>AAFTH</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><scope>5PM</scope><scope>DOA</scope><orcidid>https://orcid.org/0000-0002-4683-1454</orcidid></search><sort><creationdate>20240515</creationdate><title>Efficiency of an algorithm for the prevention of sternal infection after cardiac surgery in children under 1 year of age: A single-center retrospective study</title><author>Suvorov, V.V. ; Zaitsev, V.V. ; Gvozd, E.M.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c482t-5614ce0adc3436b8140ef496a6095819d5731acfc7a6a435591b9f4a4d166df13</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2024</creationdate><topic>Complication in pediatric cardiac surgery</topic><topic>Infection in pediatric cardiac surgery</topic><topic>Mediastinitis</topic><topic>Sternal infection</topic><topic>Sternal instability</topic><topic>Wound infection in pediatric</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Suvorov, V.V.</creatorcontrib><creatorcontrib>Zaitsev, V.V.</creatorcontrib><creatorcontrib>Gvozd, E.M.</creatorcontrib><collection>ScienceDirect Open Access Titles</collection><collection>Elsevier:ScienceDirect:Open Access</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><collection>DOAJ Directory of Open Access Journals</collection><jtitle>Heliyon</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Suvorov, V.V.</au><au>Zaitsev, V.V.</au><au>Gvozd, E.M.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Efficiency of an algorithm for the prevention of sternal infection after cardiac surgery in children under 1 year of age: A single-center retrospective study</atitle><jtitle>Heliyon</jtitle><addtitle>Heliyon</addtitle><date>2024-05-15</date><risdate>2024</risdate><volume>10</volume><issue>9</issue><spage>e29991</spage><epage>e29991</epage><pages>e29991-e29991</pages><artnum>e29991</artnum><issn>2405-8440</issn><eissn>2405-8440</eissn><abstract>Sternal infection is one of the most challenging complications to manage after heart surgery. The aim of our study is to evaluate the effectiveness of a developed algorithm for preventing sternal infection in pediatric patients after surgery for congenital heart disease (CHD). We conducted a single-center study examining the treatment of 478 children with CHD. Patients were divided into 2 groups, taking into account the application of a developed management algorithm. A multivariate logistic regression analysis was used to identify the factors influencing the development of sternal infection following heart surgery using median sternotomy. A developed algorithm was applied in 308 children. In total, there were 16 cases of sternal infection (3.34 %) across both groups. Deep wound infection developed in 6 patients (1.26 %). Sternal infection developed in 2 children (0.65 %) in the first group (in which the algorithm was applied) and 14 children (8.2 %) in the second group. Deep sternal infection developed in 1 patient in the first group (0.33 %) and in 5 patients in the second group (2.94 %). As a result, perioperative risk factors as postoperative resternotomy (OR 23.315; p &lt; 0.001), delayed sternal closure (OR 9.087; p = 0.003), development of acute renal failure (OR 5.322; p = 0.018) were associated with increased risk of infection and application of the developed algorithm resulted in a significant reduction in risk (OR 0.032; p &lt; 0.001). The suggested method for the prevention of sternal infection has significantly reduced the incidence of sternal infection after cardiac surgery in children less than 1 year of age. In patients with moderate to high risk for surgical site infection, surgeons can enhance wound healing and prevent wound infections with simple, inexpensive, and readily available tools and techniques. Surgical aspects, topical use of antibiotics, prevention of peripheral vasoconstriction, maintenance of normal oxygen delivery rates, and an individual approach to intensive care are essential.</abstract><cop>England</cop><pub>Elsevier Ltd</pub><pmid>38694077</pmid><doi>10.1016/j.heliyon.2024.e29991</doi><orcidid>https://orcid.org/0000-0002-4683-1454</orcidid><oa>free_for_read</oa></addata></record>
fulltext fulltext
identifier ISSN: 2405-8440
ispartof Heliyon, 2024-05, Vol.10 (9), p.e29991-e29991, Article e29991
issn 2405-8440
2405-8440
language eng
recordid cdi_doaj_primary_oai_doaj_org_article_9e1ecfd948384a5f8fae967dd0607518
source ScienceDirect Journals; PubMed Central
subjects Complication in pediatric cardiac surgery
Infection in pediatric cardiac surgery
Mediastinitis
Sternal infection
Sternal instability
Wound infection in pediatric
title Efficiency of an algorithm for the prevention of sternal infection after cardiac surgery in children under 1 year of age: A single-center retrospective study
url http://sfxeu10.hosted.exlibrisgroup.com/loughborough?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2025-01-03T08%3A12%3A30IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-proquest_doaj_&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Efficiency%20of%20an%20algorithm%20for%20the%20prevention%20of%20sternal%20infection%20after%20cardiac%20surgery%20in%20children%20under%201%20year%20of%20age:%20A%20single-center%20retrospective%20study&rft.jtitle=Heliyon&rft.au=Suvorov,%20V.V.&rft.date=2024-05-15&rft.volume=10&rft.issue=9&rft.spage=e29991&rft.epage=e29991&rft.pages=e29991-e29991&rft.artnum=e29991&rft.issn=2405-8440&rft.eissn=2405-8440&rft_id=info:doi/10.1016/j.heliyon.2024.e29991&rft_dat=%3Cproquest_doaj_%3E3050174231%3C/proquest_doaj_%3E%3Cgrp_id%3Ecdi_FETCH-LOGICAL-c482t-5614ce0adc3436b8140ef496a6095819d5731acfc7a6a435591b9f4a4d166df13%3C/grp_id%3E%3Coa%3E%3C/oa%3E%3Curl%3E%3C/url%3E&rft_id=info:oai/&rft_pqid=3050174231&rft_id=info:pmid/38694077&rfr_iscdi=true