Abstract：
Objectives: Analyses of incidence and time required to heal sternal wound infections after heart surgery performed via a median sternotomy between 2020 and 2022. Results: Superficial wound infections (SWI) were five times more common (2.7%) than mediastinitis (0.5%) among 2693 patients. The median time between the operation and diagnosis of SWI was 26 (interquartile range [IQR] 15-33) days vs. 16 (IQR 9-25) days for mediastinitis (p = .12). Gram-negative bacteria caused 44% of the 85 infections. Sternal wound infection correlated to higher body mass index, female sex, smoking, diabetes mellitus, previous myocardial infarction, coronary artery bypass grafting, use of internal mammary graft, and re-entry for postoperative bleeding. Eight of 59 patients (13.6%) with sternal wound infections had bilateral mammary grafts, compared to 102 of 1191 patients (8.6%) without wound infections (p = .28). Negative pressure wound therapy was always used to treat mediastinitis and applied in 63% of patients with SWI. Two of 13 patients with mediastinitis (15%) and none of 72 patients with SWI died within 90 days after the operation. The median time until the wound healed was 1.9 (IQR 1.3-3.7) months after SWI vs. 1.7 (IQR 1.3-5.3) months after mediastinitis (p = .63). Six patients (7%) required longer than one year to treat the infection. Conclusions: Postoperative sternal wound infections usually appeared several weeks after surgery and were associated with factors as high body mass index, diabetes mellitus and coronary artery bypass. SWI were more common than mediastinitis and often required negative pressure wound therapy and similar treatment time as mediastinitis.
摘要：
目标：分析2020年至2022年通过正中胸骨切开术进行心脏手术后胸骨伤口感染的发生率和愈合时间。结果：在2693例患者中，浅表伤口感染（SWI）的发生率（2.7％）是纵隔炎（0.5％）的五倍。手术与诊断SWI的中位时间为26天（四分位距[IQR]15-33天）。纵隔炎16天（IQR9-25）（p=.12）。革兰氏阴性菌导致85例感染中的44％。胸骨伤口感染与较高的体重指数相关，女性性别,吸烟,糖尿病,以前的心肌梗塞，冠状动脉旁路移植术,使用内部乳腺移植物，并重新进入术后出血。59例胸骨伤口感染患者中有8例（13.6%）有双侧乳腺移植物，1191例患者中有102例（8.6％）没有伤口感染（p=.28）。负压伤口疗法始终用于治疗纵隔炎，并在63％的SWI患者中应用。13例纵隔炎患者中有2例（15％），72例SWI患者均未在术后90天内死亡。SWI后伤口愈合的中位时间为1.9(IQR1.3-3.7)个月，与纵隔炎后1.7个月（IQR1.3-5.3）（p=.63）。6名患者（7％）需要超过一年的时间来治疗感染。结论：术后胸骨切口感染通常在术后数周出现，并与高体重指数相关。糖尿病和冠状动脉搭桥术。SWI比纵隔炎更常见，通常需要负压伤口治疗和与纵隔炎相似的治疗时间。
