La profilassi delle infezioni in chirurgia cardiovascolare

Translated title of the contribution: Infections prophylaxis in cardiovascular surgery

P. L. Vandone, V. Tolva, S. Trimarchi, V. Rampoldi, G. F. Giuffrida, E. M. Bortolani

Research output: Contribution to journalArticle

Abstract

Materials and methods. In the period 1986-1994, 2950 patients with cardiovascular diseases were surgically treated. In 2104 cases we placed biological or synthetic grafts to maintain vascular continuity. The most common has turned out to be abdominal aortic aneurysm. We treated 783 cases in emergency conditions. Staging and localization of infection has been the first aim in patients with synthetic vascular grafts. We studied signs and symptoms related to infections. In all cases we discovered the microorganism responsible of infection we started antibiotic therapy. Results. Surgical infection incidence is 4.9% (154 cases). Series analysis has evidenced a decrease in infection incidence in the period 1986-1994. The most frequent infections are: the urinary tract infection (59 cases, 38.5%) followed by surgical wound infection (37 cases, 24.1%), respiratory tract infection (27 cases, 17.5%), vascular graft infection (23 cases, 14.4%). All patients underwent a preoperative antibiotic prophylaxis with 2°-3°generation cephalosporines. We noted a higher graft infection incidence in patients treated with aortobifemoral reconstruction. We handled surgical infection following two main directions: 1-antibiotic therapy, 2-surgical treatment and antibiotic therapy. Conclusions. We noted surgical technique improvement and correct application of an antibiotic prophylaxis form has turned out to be the 'gold standard' in order to reduce cardiovascular surgical infections. To reduce sepsis or graft infection we can work on either of the following: 1) antibiotic therapy; 2) operative time reduction; 3) try to limit vascular surgery in case of concomitant gastrointestinal surgical disease; 4) using alloplastic vascular grafts with high biological compliance; 5) patency time reduction of invasive diagnostic technique.

Translated title of the contributionInfections prophylaxis in cardiovascular surgery
Original languageItalian
Pages (from-to)397-403
Number of pages7
JournalMinerva Chirurgica
Volume53
Issue number5
Publication statusPublished - May 1998

ASJC Scopus subject areas

  • Surgery

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    Vandone, P. L., Tolva, V., Trimarchi, S., Rampoldi, V., Giuffrida, G. F., & Bortolani, E. M. (1998). La profilassi delle infezioni in chirurgia cardiovascolare. Minerva Chirurgica, 53(5), 397-403.