FREQUENCY OF POST-OPERATIVE DEEP STERNAL WOUND INFECTION IN DIABETIC PATIENTS USING PEDICLE HARVESTING METHOD OF INTERNAL THORACIC ARTERY FOLLOWING CORONARY ARTERY BYPASS GRAFTING SURGERY

AU REHMAN; M AASIM; F KHALID

doi:10.54112/pjicm.v5i02.174

Authors

AU REHMAN Department of Cardiac surgery, Hayatabad Medical Complex, Peshawar, Pakistan
M AASIM Department of Cardiac surgery, Hayatabad Medical Complex, Peshawar, Pakistan
F KHALID Department of Medicine, Khyber Teaching Hospital, Peshawar, Pakistan

DOI:

https://doi.org/10.54112/pjicm.v5i02.174

Keywords:

Deep Sternal Wound Infection, Diabetes Mellitus, Coronary Artery Bypass Grafting, Pedicled Internal Thoracic Artery

Abstract

Background: Deep sternal wound infection (DSWI) is a serious postoperative complication following coronary artery bypass grafting (CABG), particularly among diabetic patients. The method of internal thoracic artery (ITA) harvesting has been implicated as a potential factor influencing infection risk, with the pedicled technique possibly predisposing to higher rates of DSWI due to impaired sternal vascularity. Objective: To determine the frequency of postoperative deep sternal wound infection (DSWI) in diabetic patients undergoing CABG using the pedicled internal thoracic artery harvesting method. Study Design: Descriptive study. Setting: Department of Cardic Surgery, Hayatabad Medical Complex, Peshawar, Pakistan. Duration of Study: From 03-February-2025 to 03-June-2025. Methods: A total of 110 diabetic patients who underwent CABG with pedicled ITA harvesting were included using consecutive non-probability sampling. Patients were monitored for 30 postoperative days for evidence of DSWI, defined by sternal instability, fever >38°C, chest pain, purulent mediastinal drainage, and positive microbiological culture from the mediastinum or blood. Data were analyzed using SPSS version 25. Results: The mean age of the study participants was 53.80 ± 13.52 years, with a male predominance (77.3%). Hypertension (71.8%) and dyslipidemia (42.7%) were common comorbidities. The frequency of DSWI was 4.5% (n=5). A significant association was observed between female gender and the occurrence of DSWI. Conclusion: The incidence of deep sternal wound infection in diabetic patients undergoing CABG with pedicled ITA harvesting was 4.5%. Female gender emerged as a notable risk factor for DSWI, highlighting the need for vigilant perioperative care in high-risk patients.

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