Evaluation of Postoperative Development of Saphenous Vein Graft Incision Site Infections in Patients Undergoing Isolated Coronary Artery Bypass Graft Surgery: A Single Center Experience

Abstract

Objective: This study aimed to evaluate surgical site infection patients developing saphenous vein graft incision site infection after isolated coronary artery bypass graft surgery performed in the cardiovascular surgery clinic of our hospital in the last 12 years to reveal the causative microorganisms, risk factors, and clinical characteristics. Material and Methods: A total of 34 surgical site infection patients (23 females, 11 males; mean age 68.0±9.0 years; range 51-86 years) who underwent isolated coronary artery bypass graft surgery in the cardiovascular surgery clinic of our hospital between March 2009 and November 2020 and who postoperatively developed saphenous vein graft incision site infection were included in the study. The patients' demographic data, underlying diseases, and preoperative, intraoperative, and postoperative risk factors were analyzed retrospectively. Results: In all isolated coronary artery bypass graft surgeries performed over a period of about 12 years, the rate of saphenous vein graft incision site surgical site infection was found to be 0.8%. Of these, 23 (67.6%) were evaluated as superficial incisional surgical site infection and 11 (32.4%) as deep incisional surgical site infection. In the patients who developed surgical site infection, the parameters of age, female sex, obesity, diabetes mellitus, smoking, emergency surgery, use of more than 1 saphenous vein graft, prolonged operation, cardiopulmonary bypass, and aortic clamp durations, intraoperative blood transfusion, length of stay in the intensive care unit, use of inotropes, and total length of hospital stay were all found to be significant. The microorganisms in purulent discharge cultures consisted of Gram-negative bacteria in 18 (53%), Gram-positive bacteria in 12 (35.3%), and fungi in 1 (2.9%). No pathogenic microorganism growth was observed in 5 (14.7%) patients. In the patients with surgical site infection, coagulase-negative staphylococci (17.6%) and Escherichia coli (17.6%) were the most frequently isolated agents. Conclusion: Particular attention should be paid to surgical site infection in patients undergoing a cardiovascular surgery intervention. It should be noted that post coronary artery bypass graft surgery surgical site infection can be reduced by determining its risk factors, modifying surgical techniques, and postoperative close monitoring of patients. Follow-up and personal care are crucial after discharge and an empirical treatment approach should be determined when an infection occurs, taking into account that coagulase-negative staphylococci and E. coli were the two leading infectious agents in our hospital.