grekovВестник хирургии имени И.И. ГрековаGrekov's Bulletin of Surgery0042-46252686-7370Federal State Budgetary Educational Institution of Higher Education «Academician I.P. Pavlov First St. Petersburg State Medical University» of the Ministry of Healthcare of the Russion Federation, FSBEI HE I.P.Pavlov SPbSMU MOH Russia10.24884/0042-4625-2015-174-5-57-60grekov-119Research ArticleОПЫТ РАБОТЫEXPERIENCE OF WORKРЕЗУЛЬТАТЫ ПРИМЕНЕНИЯ МЕТОДИКИ ЭЛИМИНАЦИИ СТЕРНАЛЬНОЙ ИНФЕКЦИИ У КАРДИОХИРУРГИЧЕСКИХ ПАЦИЕНТОВRESULTS OF APPLICATION OF THE METHOD OF STERNAL INFECTION ELIMINATION IN CARDIOSURGICAL PATIENTSХубулаваГ. Г.KhubulavaG. G.ggkh07@rambler.ruШихвердиевН. Н.ShchikhverdievN. N.narniz@mail.ruФогтП. Р.VogtP. R.paul.vogt@hirsrambler.ruМарченкоС. П.MarchenkoS. P.sergeimarchenkospb@gmail.comНаумовА. Б.NaumovA. B.naumov99@gmail.comСуворовВ. В.SuvorovV. V.vitalikkrak@gmail.comАверкинИ. И.AverkinI. I.averkin.igor@gmail.comСанкт-Петербургский государственный педиатрический медицинский университетРоссияSaint-Petersburg State Pediatric Medical UniversityRussian Federation20152810201517455760Copyright © Хубулава Г.Г., Шихвердиев Н.Н., Фогт П.Р., Марченко С.П., Наумов А.Б., Суворов В.В., Аверкин И.И., 20152015Хубулава Г.Г., Шихвердиев Н.Н., Фогт П.Р., Марченко С.П., Наумов А.Б., Суворов В.В., Аверкин И.И.Khubulava G.G., Shchikhverdiev N.N., Vogt P.R., Marchenko S.P., Naumov A.B., Suvorov V.V., Averkin I.I.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.vestnik-grekova.ru/jour/article/view/119

A retrospective analysis of cases of sternal infection development was made in 388 cardiovascular patients from 2006 to 2012. The standard preventive measures of wound infection development were applied in the first period from 2006 to 2009. The method of «elimination of sternal infection» was used in the second period from 2009 to 2012. The application of the method of «elimination of sternal infection» allowed reducing the rate of sternal infection from 7,7 to 0,5% (odds ratio 0,099,95% CI: 0,013-0,747; p=0,025). According to results of statistical analysis the most significant factors were: body mass index (p=0,002), resternotomy in early postoperative period (p<0,001), risk according EuroSCORE Logistics (p<0,001) and usage of the method of «elimination of sternal infection» (p=0,006). The prevention of postoperative infectious complications shorthens the terms of hospital stay no less than 3 weeks, improves the quality of life for the patients and decreases treatment costs on 2,5 times.

стернальная инфекцияэлиминация стернальной инфекциипрофилактика раневой инфекцииместное применение антибиотиковsternal infectionpostoperative wound infectionelimination of sternal infectionprevention of wound infectiontopical antibioticsReferencesБархатова Н. А. Особенности клинических проявлений локальной и генерализованной форм хирургической инфекции мягких тканей в детском возрасте // Педиатр. 2013. № 4. С. 18-23.Бархатова Н. А. Особенности клинических проявлений локальной и генерализованной форм хирургической инфекции мягких тканей в детском возрасте // Педиатр. 2013. № 4. С. 18-23.Baillot R., Cloutier D., Montalin L. et al. Impact of deep sternal wound infection management with vacuum-assisted closure therapy followed by sternal osteosynthesis: a 15-year review of 23,499 sternotomies // Eur. J. Cardiothorac. Surg. 2010. Vol. 37. P. 880-887.Baillot R., Cloutier D., Montalin L. et al. Impact of deep sternal wound infection management with vacuum-assisted closure therapy followed by sternal osteosynthesis: a 15-year review of 23,499 sternotomies // Eur. J. Cardiothorac. Surg. 2010. Vol. 37. P. 880-887.Dalfino L., Giglio M. T., Puntillo F. et al. Haemodynamic goal-directed therapy and postoperative infections: earlier is better. a systematic review and meta-analysis // Critical Care. 2011. Vol. 15, Is. 3. P. 154.Dalfino L., Giglio M. T., Puntillo F. et al. Haemodynamic goal-directed therapy and postoperative infections: earlier is better. a systematic review and meta-analysis // Critical Care. 2011. Vol. 15, Is. 3. P. 154.Eklund A. M., Lyytikainen O., Klemets P. et al. Mediastinitis after more than 10,000 cardiac surgical procedures // Ann. Thorac. Surg. 2006. Vol. 82. P. 1784-1789.Eklund A. M., Lyytikainen O., Klemets P. et al. Mediastinitis after more than 10,000 cardiac surgical procedures // Ann. Thorac. Surg. 2006. Vol. 82. P. 1784-1789.Filsoufi F., Castillo J. G., Rahmanian P. B. et al. Epidemiology of deep sternal wound infection in cardiac surgery // J. Cardiothorac. Vasc. Anesth. 2009. Vol. 23. P. 488-494.Filsoufi F., Castillo J. G., Rahmanian P. B. et al. Epidemiology of deep sternal wound infection in cardiac surgery // J. Cardiothorac. Vasc. Anesth. 2009. Vol. 23. P. 488-494.Hoffman S. N., TenBrook J. A., Wolf M. P. et al. A meta-analysis of randomized controlled trialscomparing coronary artery bypass graft with percutaneous transluminal coronary angioplasty: one-to eight-year outcomes // J. Am. Coll. Cardiol. 2003. Vol. 41. P. 1293-1304.Hoffman S. N., TenBrook J. A., Wolf M. P. et al. A meta-analysis of randomized controlled trialscomparing coronary artery bypass graft with percutaneous transluminal coronary angioplasty: one-to eight-year outcomes // J. Am. Coll. Cardiol. 2003. Vol. 41. P. 1293-1304.Hollenbeak C. S., Murphy D. M., Koenig S. et al. The clinical and economic impact of deep chest surgical site infections following coronary artery bypass graft surgery // Chest. 2000. Vol. 118. P. 397-402.Hollenbeak C. S., Murphy D. M., Koenig S. et al. The clinical and economic impact of deep chest surgical site infections following coronary artery bypass graft surgery // Chest. 2000. Vol. 118. P. 397-402.Karra R., McDermott L., Connelly S. et al. Risk factors for 1-year mortality after postoperative mediastinitis // J. Thorac. Cardiovasc. Surg. 2006. Vol. 132. P. 537-543.Karra R., McDermott L., Connelly S. et al. Risk factors for 1-year mortality after postoperative mediastinitis // J. Thorac. Cardiovasc. Surg. 2006. Vol. 132. P. 537-543.Risnes I., Abdelnoor M., Almdahl S. M., Svennevig J. L. Mediastinitis after coronary artery bypass grafting risk factors and long-term survival // Ann. Thorac. Surg. 2010. Vol. 89. P. 1502-1510.Risnes I., Abdelnoor M., Almdahl S. M., Svennevig J. L. Mediastinitis after coronary artery bypass grafting risk factors and long-term survival // Ann. Thorac. Surg. 2010. Vol. 89. P. 1502-1510.Sachithanandan A., Nanjaiah P., Nightingale P. et al. Deep sternal wound infection requiring revision surgery: impact on mid-term survival following cardiac surgery // Eur. J. Cardiothorac. Surg. 2008. Vol. 33. P. 673-678.Sachithanandan A., Nanjaiah P., Nightingale P. et al. Deep sternal wound infection requiring revision surgery: impact on mid-term survival following cardiac surgery // Eur. J. Cardiothorac. Surg. 2008. Vol. 33. P. 673-678.Sarr M. G., Gott V. L., Townsend T. R. Mediastinal infection after cardiac surgery // Ann. Thorac. Surg. 1984. Vol. 38. P. 415-423.Sarr M. G., Gott V. L., Townsend T. R. Mediastinal infection after cardiac surgery // Ann. Thorac. Surg. 1984. Vol. 38. P. 415-423.Speir A. M., Kasirajan V., Barnett S. D., Fonner E. Additive costs of postoperative complications for isolated coronary artery bypass grafting patients in Virginia // Ann. Thorac. Surg. 2009. Vol. 88. P. 40-46.Speir A. M., Kasirajan V., Barnett S. D., Fonner E. Additive costs of postoperative complications for isolated coronary artery bypass grafting patients in Virginia // Ann. Thorac. Surg. 2009. Vol. 88. P. 40-46.

The authors declare that there are no conflicts of interest present.