Post-CABG Deep Sternal Wound Infection: A Retrospective Comparative Analysis of Early versus Late Referral to a Plastic Surgery Unit in a Tertiary Care Center
Background Deep sternal wound infections (DSWI) following median sternotomy are initially treated by the cardiothoracic surgeons and are referred to a plastic surgical unit late in the course of time. Methods This is a retrospective review done in a tertiary care teaching institute from January 200...
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Thieme Medical and Scientific Publishers Pvt. Ltd.
2021-04-01
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| Series: | Indian Journal of Plastic Surgery |
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| Online Access: | http://www.thieme-connect.de/DOI/DOI?10.1055/s-0041-1731256 |
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| author | Parag B. Sahasrabudhe Mugdha D. Pradhan Nikhil Panse Ranjit Jagtap |
| author_facet | Parag B. Sahasrabudhe Mugdha D. Pradhan Nikhil Panse Ranjit Jagtap |
| author_sort | Parag B. Sahasrabudhe |
| collection | DOAJ |
| description | Background Deep sternal wound infections (DSWI) following median sternotomy are initially treated by the cardiothoracic surgeons and are referred to a plastic surgical unit late in the course of time.
Methods This is a retrospective review done in a tertiary care teaching institute from January 2005 to June 2018 and the data of 72 patients who had DSWI out of 4,214 patients who underwent median sternotomy for coronary artery bypass grafting (CABG) was collected with respect to the duration between CABG and presentation of DSWI as well as time of referral to a plastic surgery unit. We defined early referral as < or equal to 15 days from presentation and late referral as > 15 days. Both groups were compared with respect to multiple parameters as well as early and late postoperative course, postoperative complications, and mortality.
Results The early group had 33 patients, while the late group had 39 patients. The number of procedures done by the cardiothoracic team before referral to the plastic surgery unit is significant (p = 0.002). The average duration from the presentation of DSWI to definitive surgery was found to be 16.58 days in the early group and 89.36 days in the late group. The rest of the variables that were compared in both the groups did not have significant differences.
Conclusion There is no statistical difference between early and late referral to plastic surgery in terms of mortality and morbidity. Yet, early referrals could lead to highly significant reduction in total duration of hospital stay, wound healing, and costs. Early referral of post-CABG DSWIs to Plastic surgeons by the cardiothoracic surgeons is highly recommended. |
| format | Article |
| id | doaj-art-ac433b5e225547d397ae27f5ac2920ff |
| institution | Kabale University |
| issn | 0970-0358 1998-376X |
| language | English |
| publishDate | 2021-04-01 |
| publisher | Thieme Medical and Scientific Publishers Pvt. Ltd. |
| record_format | Article |
| series | Indian Journal of Plastic Surgery |
| spelling | doaj-art-ac433b5e225547d397ae27f5ac2920ff2025-08-20T03:24:30ZengThieme Medical and Scientific Publishers Pvt. Ltd.Indian Journal of Plastic Surgery0970-03581998-376X2021-04-01540215716210.1055/s-0041-1731256Post-CABG Deep Sternal Wound Infection: A Retrospective Comparative Analysis of Early versus Late Referral to a Plastic Surgery Unit in a Tertiary Care CenterParag B. Sahasrabudhe0Mugdha D. Pradhan1Nikhil Panse2Ranjit Jagtap3Department of Plastic Surgery, Deenanath Mangeshkar Hospital & Research Centre, Pune, Maharashtra, IndiaDepartment of Plastic Surgery, Deenanath Mangeshkar Hospital & Research Centre, Pune, Maharashtra, IndiaDepartment of Plastic Surgery, B.J. Medical Govt. College & Sassoon Hospitals, Pune, Maharashtra, IndiaDepartment of Cardiothoracic Surgery, Deenanath Mangeshkar Hospital & Research Centre, Maharashtra, IndiaBackground Deep sternal wound infections (DSWI) following median sternotomy are initially treated by the cardiothoracic surgeons and are referred to a plastic surgical unit late in the course of time. Methods This is a retrospective review done in a tertiary care teaching institute from January 2005 to June 2018 and the data of 72 patients who had DSWI out of 4,214 patients who underwent median sternotomy for coronary artery bypass grafting (CABG) was collected with respect to the duration between CABG and presentation of DSWI as well as time of referral to a plastic surgery unit. We defined early referral as < or equal to 15 days from presentation and late referral as > 15 days. Both groups were compared with respect to multiple parameters as well as early and late postoperative course, postoperative complications, and mortality. Results The early group had 33 patients, while the late group had 39 patients. The number of procedures done by the cardiothoracic team before referral to the plastic surgery unit is significant (p = 0.002). The average duration from the presentation of DSWI to definitive surgery was found to be 16.58 days in the early group and 89.36 days in the late group. The rest of the variables that were compared in both the groups did not have significant differences. Conclusion There is no statistical difference between early and late referral to plastic surgery in terms of mortality and morbidity. Yet, early referrals could lead to highly significant reduction in total duration of hospital stay, wound healing, and costs. Early referral of post-CABG DSWIs to Plastic surgeons by the cardiothoracic surgeons is highly recommended.http://www.thieme-connect.de/DOI/DOI?10.1055/s-0041-1731256deep sternal wound infection (dswi)negative pressure wound therapyomental flappectoralis major muscle flapssternal dehiscence |
| spellingShingle | Parag B. Sahasrabudhe Mugdha D. Pradhan Nikhil Panse Ranjit Jagtap Post-CABG Deep Sternal Wound Infection: A Retrospective Comparative Analysis of Early versus Late Referral to a Plastic Surgery Unit in a Tertiary Care Center Indian Journal of Plastic Surgery deep sternal wound infection (dswi) negative pressure wound therapy omental flap pectoralis major muscle flaps sternal dehiscence |
| title | Post-CABG Deep Sternal Wound Infection: A Retrospective Comparative Analysis of Early versus Late Referral to a Plastic Surgery Unit in a Tertiary Care Center |
| title_full | Post-CABG Deep Sternal Wound Infection: A Retrospective Comparative Analysis of Early versus Late Referral to a Plastic Surgery Unit in a Tertiary Care Center |
| title_fullStr | Post-CABG Deep Sternal Wound Infection: A Retrospective Comparative Analysis of Early versus Late Referral to a Plastic Surgery Unit in a Tertiary Care Center |
| title_full_unstemmed | Post-CABG Deep Sternal Wound Infection: A Retrospective Comparative Analysis of Early versus Late Referral to a Plastic Surgery Unit in a Tertiary Care Center |
| title_short | Post-CABG Deep Sternal Wound Infection: A Retrospective Comparative Analysis of Early versus Late Referral to a Plastic Surgery Unit in a Tertiary Care Center |
| title_sort | post cabg deep sternal wound infection a retrospective comparative analysis of early versus late referral to a plastic surgery unit in a tertiary care center |
| topic | deep sternal wound infection (dswi) negative pressure wound therapy omental flap pectoralis major muscle flaps sternal dehiscence |
| url | http://www.thieme-connect.de/DOI/DOI?10.1055/s-0041-1731256 |
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