摘要 |
From July 1989 to June 1998, 43 sternal wound infections developed in 1491 open-heart surgery patients at National Cheng-Kung University Hospital. The incidence was 2.9%. The most frequently isolated pathogen was staphylococcus coagulase (-). The primary closure method was used for 24 patients and flap surgery for 19, which included a pectoralis major muscle flap in 8 cases, a rectus abdominis muscle flap in 4 an omental flap in 1, and a combination of pectoralis muscle and rectus abdominis muscle flap in 6. The total recurrence rate was 28% (12/43). the mortality rate was 9.3% (4/43) with wound sepsis in two of these patients. Type ! sternal wound infection can be treated with primany closure, while type 2 and 3 wounds can be treated with flap coverage. Univariate analysis with a chi-square test indicated that there was a significant difference between recurrence and onset of infection (p<0.05), but no significant difference between recurrence and other factors (age, sex, type of open-heart surgery, surgical method, classification of wound, and use of internal mammary artery). |