Focus on sternal wound infection prevention and management in cardiac surgery

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Olga Lender

Cleveland Clinic Abu Dhabi, UAE

: J Regen Med

Abstract

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Cardiac surgery carries the risk of various complications, and sternal wound infection (SWI) stands out as a serious concern. Although global incidence rates vary, this complication disproportionately affects a specific patient demographic. This presentation employs comprehensive risk assessment strategies to identify high-risk patient profiles. It draws parallels between positive predictors in the preoperative, intraoperative, and postoperative stages, as well as focuses on guidelines for detection and treatment. Risk factors: Risk factors associated with SWI are explored in relation to the fundamental components of sternal wound healing: stable osteosynthesis, infection control, and optimal perfusion. The interdependence of these components forms a defence network against infection, with any breach potentially leading to SWI. Notably, conditions such as obesity, chronic obstructive pulmonary disease (COPD), insulin-dependent diabetes, and renal failure are strongly correlated with deep SWI. Discussion: The ensuing discussion navigates the diverse therapeutic avenues for managing SWI in cardiac surgery. These options are contingent upon hospital protocols, clinical judgments, patient factors and surgeon preferences. Central to proper sternal wound healing is optimization of sternal stability, which dictates criteria for successful primary wound closure. The literature indicates that Vacuum-Assisted Closure (VAC) therapy emerges as a superior alternative for secondary wound closure, offering a distinct advantage over conventional methods. Conclusion: The literature emphasizes that robust risk stratification, combined with adherence to SWI prevention guidelines, holds the potential to curtail the incidence of sternal complications. This presentation underscores the significance of a comprehensive approach to SWI management, ultimately contributing to enhanced patient outcomes.

Biography

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Olga Lender, PA-C, is an accomplished healthcare professional with a profound commitment to patient care and safety. She is a member of the American Association of Physician Assistants and the Association of Physician Assistants in Cardiothoracic and Vascular Surgery. With a decade of experience in cardiac surgery, she has consistently strived for excellence in patient care. Olga's journey in cardiac surgery began within the walls of Cleveland Clinic, Ohio, where her dedication to the field truly took root. For the last five years she has been part of Cleveland Clinic Abu Dhabi family, enriching their cardiac surgery practice. A strong advocate for ongoing education and professional development, Olga continually seeks to expand her knowledge. She has authored two publications, with one of them focusing on prevention and management of sternal wound infections after sternotomy. Her passion for providing support for patient safety has been at the forefront of her career.