Prevalence of infections in surgical sutures on myocardial revascularization surgery

Taciane Procópio Assunção^I; Breno César Diniz Pontes^II; Carlos Américo Veiga Damasceno^III

DOI: 10.1590/S0102-76382011000100010

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INTRODUCTION

Infection in surgery can be regarded as being the result of the invasion, proliferation, metabolic activity and consequent pathophysiologic effects of microorganisms on tissue from an individual. Constitutes the most common complication of tissue synthesis, becoming a constant worry for surgeons. Their incidence is affected by a number of variables, for example, the degree of contamination of the wound, the surgical technique and materials used for synthesis [1].

One of the types of infections resulting from coronary artery bypass grafting is occurring in sutures. The incidence of these should be the same as for any clean surgical procedure, ie around 2%. However the infection rate reaches three times among patients with heart disease, because they had more risk factors than the general population. As for deep wound infection, the incidence is 0.5% to 5% [2].

Due to the higher susceptibility to infection demonstrated in cardiac patients by their weakness, the high costs of treating these infections cause and intensity with which they occur, was studied by De Feo [3] in cardiac surgery patients often do happen and trying to to relate some variables to their incidence.

In cardiac surgery, surgical wound infection by Staphylococcus aureus, and increased length of hospital within 30 days, significantly increases mortality. Hospital infection, surgical site infection is the second most frequent cause, surpassed only by urinary tract infection. The microorganisms most commonly associated with surgical site infection are Staphylococcus aureus, coagulase negative and Gram-negative [4].

This study aims to examine the surgical site infections occurred in surgeries such as CABG its causing microorganisms in order to study the local microbial flora and to correlate its incidence with age and sex of patients.


METHODS

This is a retrospective study, in which during the period 1 January 2007 to December 31, 2009, 357 patients underwent coronary artery bypass grafting in Hospital Samuel Libanius, a university hospital in the town of Pouso Alegre, Brazil.

Of all patients who underwent coronary artery bypass grafting, 21 had infections due to the intervention, and were classified as surgical site infection through the HICC (Commission on Hospital Infection Control) that follows the parameters of the NIS. Their charts were reviewed in 2009 and 2010.

The variables analyzed were gender, age, organisms found at points of infection and the prevalence of these infections in HCSL.

This study was approved by the Ethics in Research Committee of Vale do Sapucaí, registration number 1038/08.

To analyze the results, we applied the chi-square [5], in order to compare the years 2007, 2008 and 2009 regarding the presence of infections.


RESULTS

During the year 2007 were 101 coronary artery bypass grafting. Of this total, six patients (5.94%) had infection in post-surgical suture.

In 2008, there were 119 surgeries, and seven (5.88%) developed infection of the suture.

In 2009, 137 surgeries were performed and eight (5.88%) developed infection.

During these three years, two deaths were recorded, but none due to surgical infection.

The chi-square analysis showed no significant difference between the years 2007, 2008 and 2009 when compared in terms of percentage of cases with infection, with an average of 3 years 5.88% (Table 1).




No significant changes in the distribution of patients according to sex (Figure 1).