Incidence of sternocutaneous fistulas following open heart surgery in a nationwide cohort

We studied the incidence and characteristics of surgically treated sternocutaneous fistulas in a nationwide cohort of patients undergoing open heart surgery in Iceland. Between 2000 and 2010, sternocutaneous fistulas were treated surgically in 6 out of 2446 patients undergoing open heart surgery (in...

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Bibliographic Details
Published in:Scandinavian Journal of Infectious Diseases
Main Authors: Steingrimsson, Steinn, Sjögren, Johan, Gudbjartsson, Tomas
Format: Text
Language:English
Published: Informa Healthcare 2012
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Online Access:https://lup.lub.lu.se/record/3079994
https://doi.org/10.3109/00365548.2012.669842
Description
Summary:We studied the incidence and characteristics of surgically treated sternocutaneous fistulas in a nationwide cohort of patients undergoing open heart surgery in Iceland. Between 2000 and 2010, sternocutaneous fistulas were treated surgically in 6 out of 2446 patients undergoing open heart surgery (incidence 0.25%, 95% confidence interval 0.11-0.53%). All patients were male, with a mean age of 71 +/- 9 y. In addition to antibiotic treatment, debridement of the wound was performed in all cases. Staphylococcus aureus and/or coagulase-negative staphylococci were identified as pathogens in 5 cases and Candida albicans in 1. Chronic infections developed in 3 patients who were treated repeatedly, 1 of them unsuccessfully. Inhospital stay ranged from 0 to 50 days (mean 19 days). Sternocutaneous fistulas are rare, but since they may have a devastating course, increased awareness of this infectious complication of open heart surgery is important.