Analysis of the Results of the Introduction of the Protocol for Prevention of Wound Complications After Heart Surgery

We present our results after the implementation of the protocol for prevention of wound complications following open heart surgery introduced in the Department of Cardiac Surgery, University Hospital „St. Marina“, Varna in January 2014, as well as short data from our studies of risk factors for wound infection.Aim: The aim of this paper is introduction of a uniform protocol for assessing preoperative risk, preparing patients for surgery, behavior in the operating room and in the postoperative period to reduce the incidence of postoperative infection of the chest wound and thus enhancing the quality of life of patients, reducing the hospital stay and optimizing the financial costs; identification of risk factors for wound infection and analysis of the epidemiology of postoperative wound infections.Materials and Methods: We conducted studies on potential risk factors responsible for the development of postoperative wound infection of the chest wall in 1354 consecutive patients from January, 2011 to September, 2013 and 505 patients from January, 2014 to December, 2014. Standard descriptive statistics were used.Results: After processing the data and a comparison with a control group we found that the proportion of wound infections before the introduction of the protocol for the prevention of wound complications (cases 2011-2013) is greater than the proportion of wound infections after its introduction.The following can be marked can be marked as significant risk factors for wound infection after cardiac surgery operation in our clinic: diabetes mellitus, BMI> 25, the duration of mechanical pulmonary ventilation in the ICU, chronic congestive heart failure and low albumin levels.Conclusions: Strict compliance with the protocol for the prevention of wound infection leads to a significant reduction in wound complications.The risk factors for wound infection that we find significant within our clinic are comparable to the reported sources in the world.The reduction in body weight and strict glycemic control would reduce the risk of wound complications.