HSC01
clear graphic
clear graphic

Protocol reduces sternal wound infections in children

Posted on Tuesday, March 06, 2012 · Volume: XLV · Issue: 5

Contact: Will Sansom, 210-567-2579


S. Adil Husain, M.D., of UT Medicine San Antonio, noted that the study was begun because there was no standardized manner used by hospitals across the country to prevent sternal wound infections in children. He is an associate professor of cardiothoracic surgery in the School of Medicine.
clear graphic
S. Adil Husain, M.D., of UT Medicine San Antonio, noted that the study was begun because there was no standardized manner used by hospitals across the country to prevent sternal wound infections in children. He is an associate professor of cardiothoracic surgery in the School of Medicine.clear graphic

Email Printer Friendly Format
 

SAN ANTONIO (Feb. 27, 2012) — A two-year effort to prevent infections in children healing from cardiac surgery reduced sternum infections by 61 percent, a San Antonio researcher announced at the Cardiology 2012 conference Feb. 23 in Orlando, Fla.

Faculty from UT Medicine San Antonio carried out a new infection-control protocol for 308 children who underwent sternotomies at CHRISTUS Santa Rosa Children’s Hospital between 2009 and 2011. UT Medicine is the clinical practice of the School of Medicine at The University of Texas Health Science Center at San Antonio.

Approach to children not standardized
A sternotomy is a surgical incision through the sternum. The study, published in The Annals of Thoracic Surgery, was the follow-up to an initial nationwide, multi-institutional study carried out by the group in 2009. The first study revealed that programs across the country had no standardized manner in which to prevent sternal wound infections. “This was noted to be of concern, as the adult cardiac surgical population has well-described protocols to prevent such infections,” said S. Adil Husain, M.D., of UT Medicine San Antonio. He is associate professor of surgery in the School of Medicine, where he also serves as chief of the Division of Pediatric Cardiothoracic Surgery/Congenital Heart Network.

Multiple interventions implemented
The protocol tested in the follow-up study included preoperative baths with a skin disinfectant, the use of disposable, single-use electrodes and administration of antibiotics no longer than an hour before the start of surgery. The number of sternal wound infections decreased from 14 the first year of the study to five the second year.

The sternum, also called the breastbone, anchors the rib cage protecting the heart and lungs. To correct congenital heart defects, surgeons in many cases must break open the sternum to gain access to the operation site. More than 350 pediatric cardiac surgical cases are performed annually at the children’s hospital with the sternum being opened at least 75 percent of the time.

Deep infections may involve areas around heart
“Sternal wound infection is relatively infrequent; however, when it occurs it increases the child’s length of stay and recovery time,” said Cathy Woodward, D.N.P., RN, PNP-AC, of UT Medicine San Antonio and assistant professor of pediatrics in the School of Medicine. “The bone, muscle and tissue around the heart can become involved when the infection is deep.”


Cathy Woodward, D.N.P., RN, PNP-AC, of UT Medicine San Antonio and an assistant professor of pediatrics in the School of Medicine, presented the findings at the Cardiology 2012 conference Feb. 23 in Orlando, Fla.
clear graphic
Cathy Woodward, D.N.P., RN, PNP-AC, of UT Medicine San Antonio and an assistant professor of pediatrics in the School of Medicine, presented the findings at the Cardiology 2012 conference Feb. 23 in Orlando, Fla.clear graphic

 

Dr. Woodward presented the clinical findings in Orlando. The team also included Dr. Husain and critical care specialists Minnette Son, M.D., professor of pediatrics, and Richard Taylor, M.D., associate professor of pediatrics.

Multicenter study would be logical next step
Children from newborns to age 18 were included in the study. Using a protocol for children with delayed closure of the sternum also produced a lower infection rate, although it was not statistically significant.

“Because we had so few infections, we don’t have enough statistical power to analyze these results,” Dr. Woodward said. “This pilot finding lends itself to the need to do a multicenter study.”

# # #

UT Medicine San Antonio is the clinical practice of the School of Medicine at the UT Health Science Center at San Antonio. With more than 700 doctors — all faculty members from the School of Medicine — UT Medicine San Antonio is the largest medical practice in Central and South Texas, with expertise in more than 60 different branches of medicine. Primary care doctors and specialists see patients in private practice at UT Medicine’s clinical home, the Medical Arts & Research Center (MARC), located in the South Texas Medical Center at 8300 Floyd Curl Drive, San Antonio 78229. Most major health plans are accepted, and there are clinics and physicians at several local and regional hospitals, including CHRISTUS Santa Rosa, University Hospital and Baptist Medical Center. Call 210-450-9000 to schedule an appointment, or visit www.UTMedicine.org for a complete list of clinics and phone numbers.

 
Share |

Top stories this week »



bottom bar

printer friendly format »
view more articles by issue »
search articles by keywords »
Arrow - to top
Arrow - to top