Abstract
BackgroundBacterial mediastinitis is a severe complication after open heart surgery. The infection causes prolonged hospitalization and an increased mortality risk. Observations from orthopaedic surgery showed that the suction catheter used during surgery is commonly contaminated with bacteria. The aim of this study was to describe the prevalence of suction catheter contamination in cardiac surgery and to study if suction time influences the contamination risk.MethodsFifty suction catheter tips were collected during 25 aortic valve replacement operations. The suction tip was exchanged once during the operation (after aortotomy closure). The tips were subjected to bacterial contamination analysis.ResultsIn 20 of the 25 investigated cases (80%), bacterial contamination was detected on one or both tips. The tip used during the beginning of the operation showed bacterial contamination in 13/25 cases (52%) and the second tip in 12/25 (48%). In 5/25 cases (20%) both tips were contaminated. There was no association between bacterial contamination and suction time. Coagulase-negative staphylococcus was the most commonly detected microorganism.ConclusionsThe suction device should be considered as a potential source of bacterial contamination in cardiac surgery. The results suggest that the suction catheter should be replaced before key moments like valve implantation and sternal closure.
Highlights
Bacterial mediastinitis is a severe complication after open heart surgery
Since no data is available from cardiac surgery, the aim of this study was to investigate contamination of suction catheter tips during aortic valve replacement and to study if suction time is a factor that increases the risk of contamination
In our study, bacterial contamination was detected in 80% in one or both of the suction catheter tips and that contamination can be detected both during and in the end of the operation
Summary
Bacterial mediastinitis is a severe complication after open heart surgery. The infection causes prolonged hospitalization and an increased mortality risk. Bacteria are commonly found in surgical wounds at the end of surgery [1,2]. A small quantity of bacteria with low virulence is harmless because the body’s own immunological defence can eliminate it but if the bacterial load is large it can cause surgical site infections (SSI) [3]. In the end of the operation, sternum is closed with stainless steel wires. Mediastinitis is a deep chest infection, which can emerge postoperatively after open-heart surgery. Mediastinitis affects 0.5-4% (usually 1%) of all patients who undergoes open-heart surgery and increases the mortality risk [4,8,9]. Larsson et al Patient Safety in Surgery (2015) 9:17 one-year mortality was 22% in patients with mediastinitis compared to 0.6% in patients without mediastinitis [4]
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