Abstract
BackgroundThe aim of this prospective study is to evaluate the role in the onset of surgical site infections of bilateral internal thoracic arteries harvesting in patients with decompensated preoperative glycemia.Methods81 consecutive patients with uncontrolled diabetes mellitus underwent elective CABG harvesting single or double internal thoracic arteries. Single left ITA was harvested in 41 patients (Group 1, 50.6%), BITAs were harvested in 40 (Group 2, 49.4%). The major clinical end points analyzed in this study were infection rate, type of infection, duration of infection, infection relapse rate and total hospital length of stay.ResultsFive patients developed sternal SSI in the perioperative period, 2 in group 1 and 3 in group 2 without significant difference. All sternal SSIs were superficial with no sternal dehiscence. The development of infection from the time of surgery took 18.5 ± 2.1 and 7.3 ± 3.0 days for Groups 1 and 2 respectively. The infections were treated with wound irrigation and debridement, and with VAC therapy as well as with antibiotics. The VAC system was removed after a mean of 12.8 ± 5.1 days, when sterilization was achieved. The overall survival estimate at 1 year was 98.7%. Only BMI was a significant predictor of SSI using multivariate stepwise logistic regression analysis (Odds Ratio: 1.34; 95%Conficdence Interval: 1.02–1.83; p value: 0.04). In the model, the use of BITA was not an independent predictor of SSI.ConclusionCABG with bilateral pedicled ITAs grafting could be performed safely even in diabetics with poor preoperative glycaemic control.
Highlights
The aim of this prospective study is to evaluate the role in the onset of surgical site infections of bilateral internal thoracic arteries harvesting in patients with decompensated preoperative glycemia
It had been related to the indications for performing bilateral internal thoracic arteries (BITAs) harvesting, younger age and good preoperative clinical status being an indication to BITA coronary artery bypass grafting (CABG)
There were no significant differences in gender, number of diseased vessels, and comorbidities between groups
Summary
The aim of this prospective study is to evaluate the role in the onset of surgical site infections of bilateral internal thoracic arteries harvesting in patients with decompensated preoperative glycemia. The role of diabetes in the onset of surgical site infections (SSI) is well established, especially in patients with uncontrolled-glycaemia levels[1]. It represents a predisposing factor, as it leads to microvascular alterations and decreased wound healing [2,3]. The harvesting of internal thoracic artery (ITA) for coronary artery bypass grafting (CABG) leads to an acute decrease of the sternal circulation [5]. The sternal wound is exposed to increased risk of dehiscence and SSI by its nature, especially when other risk factors are present
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
