In a recent Editorial published in Medical Microbiology & Diagnosis, Dohmen (2013)1 reviews some of the clinical evidence surrounding Surgical Site Infections (SSI) in Cardiac surgery. Superficial and deep post-sternotomy infections after cardiac sugery remains an important cause of morbidity and mortality, described in the literature with an incidence up to 15%.1
As both transient and residential skin flora will play different roles in superficial and deep post-sternotomy infections (Staphyloccocus Aureus, part of transient skin flora is seen more often in deep infection while Coagulase-negative staphylococci is most likely to be involved in superficial infection)2, it has been recognised that appropriate disinfecting strategies must be considered to manage transient and residential skin flora.1
As surgical case loads are progressively more complex and high-risk patients are increasingly common, it's more critical than ever to protect against post-operative complications.
"There is an economic burden associated associated with SSI, especially in patients suffering from post sternotomy medistinitis after cardiac surgery. The literature normally only reports only on hospital costs due to prolonged hospitalization and re-admission. Generally, the prolonged hospital stay of patients suffering from SSI is 10 days, in cardiac surgery even 12 days, which results in extra costs estimated to be around 19 billions Euros each year in Europe."1,3
As mentioned by Dohmen (2013)1, the hospital cost due to additional hospitalisation days to treat SSI is only a limited part apart of the direct health costs of patients treated with SSI. The most important part of the economic burden due to SSI are the indirect costs due to temporary or permanent incapacity to work, expressed in years of productive life lost, morbidity, mortality, income lost by family members, forgone leisure time, travel costs, home care costs.1
Alfonso et al.4 have been investigating both the direct and indirect costs of surgical site infection in Spain. It was shown that indirect costs related to SSI exceeded direct costs by about 8 times when taking into account years of productive life lost (total of 106 patients of which 74 were over 60 and 8 below the age of 40). 1,4
- Dohmen PM (2013) Economic Burden of Surgical Site Infections in Cardiac Surgery, J Med Microb Diagn, 2:3.
- Sharma M, Berriel-Cass D, Baran J Jr (2004) Sternal surgical-site infection following coronary artery bypass graft: prevalence, microbiology, and complications during a 42-month period. Infect Control Hosp Epidemiol 25: 468-471.
- Dohmen PM (2008) Antiobiotic resistance in common pathogens reinforces the need to minimize surgical site infections. J Josp Infect 70: 15-20.
- Alfonso JL, Pereperez SB, Canoves JM, Martinez MM, et al. (2007) Are we really seeing the total costs of surgical site infections? A Spanish study. Wound Repair Regen 15: 474-481.