Double vs single internal thoracic artery harvesting in diabetic patients: role in perioperative infection rate

<p<Abstract</p< <p<Background</p< <p<The aim of this prospective study is to evaluate the role in the onset of surgical site infections of bilateral internal thoracic arteries harvesting in patients with decompensated preoperative glycemia.</p< <p<Methods<...
Ausführliche Beschreibung

Gespeichert in:

Autor*in:	Parolari Alessandro [verfasserIn] Polvani Gianluca [verfasserIn] Ghislandi Chiara [verfasserIn] Topkara Veli K [verfasserIn] Cheema Faisal H [verfasserIn] Dainese Luca [verfasserIn] Barili Fabio [verfasserIn] Trezzi Matteo [verfasserIn] Agrifoglio Marco [verfasserIn] Alamanni Francesco [verfasserIn] Biglioli Paolo [verfasserIn]

Format:	E-Artikel
Sprache:	Englisch

Erschienen:	2008

Übergeordnetes Werk:	In: Journal of Cardiothoracic Surgery - BMC, 2006, 3(2008), 1, p 35
Übergeordnetes Werk:	volume:3 ; year:2008 ; number:1, p 35

Links:	Link aufrufen Link aufrufen Link aufrufen Journal toc

DOI / URN:	10.1186/1749-8090-3-35

Katalog-ID:	DOAJ042760402

Internformat


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allfields	10.1186/1749-8090-3-35 doi (DE-627)DOAJ042760402 (DE-599)DOAJac6109be48cf47529fe2bae7a16f8447 DE-627 ger DE-627 rakwb eng RD1-811 RD78.3-87.3 Parolari Alessandro verfasserin aut Double vs single internal thoracic artery harvesting in diabetic patients: role in perioperative infection rate 2008 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier <p<Abstract</p< <p<Background</p< <p<The aim of this prospective study is to evaluate the role in the onset of surgical site infections of bilateral internal thoracic arteries harvesting in patients with decompensated preoperative glycemia.</p< <p<Methods</p< <p<81 consecutive patients with uncontrolled diabetes mellitus underwent elective CABG harvesting single or double internal thoracic arteries. Single left ITA was harvested in 41 patients (Group 1, 50.6%), BITAs were harvested in 40 (Group 2, 49.4%). The major clinical end points analyzed in this study were infection rate, type of infection, duration of infection, infection relapse rate and total hospital length of stay.</p< <p<Results</p< <p<Five patients developed sternal SSI in the perioperative period, 2 in group 1 and 3 in group 2 without significant difference. All sternal SSIs were superficial with no sternal dehiscence. The development of infection from the time of surgery took 18.5 ± 2.1 and 7.3 ± 3.0 days for Groups 1 and 2 respectively. The infections were treated with wound irrigation and debridement, and with VAC therapy as well as with antibiotics. The VAC system was removed after a mean of 12.8 ± 5.1 days, when sterilization was achieved. The overall survival estimate at 1 year was 98.7%. Only BMI was a significant predictor of SSI using multivariate stepwise logistic regression analysis (Odds Ratio: 1.34; 95%Conficdence Interval: 1.02–1.83; p value: 0.04). In the model, the use of BITA was not an independent predictor of SSI.</p< <p<Conclusion</p< <p<CABG with bilateral pedicled ITAs grafting could be performed safely even in diabetics with poor preoperative glycaemic control.</p< Surgery Anesthesiology Polvani Gianluca verfasserin aut Ghislandi Chiara verfasserin aut Topkara Veli K verfasserin aut Cheema Faisal H verfasserin aut Dainese Luca verfasserin aut Barili Fabio verfasserin aut Trezzi Matteo verfasserin aut Agrifoglio Marco verfasserin aut Alamanni Francesco verfasserin aut Biglioli Paolo verfasserin aut In Journal of Cardiothoracic Surgery BMC, 2006 3(2008), 1, p 35 (DE-627)509401260 (DE-600)2227224-0 17498090 nnns volume:3 year:2008 number:1, p 35 https://doi.org/10.1186/1749-8090-3-35 kostenfrei https://doaj.org/article/ac6109be48cf47529fe2bae7a16f8447 kostenfrei http://www.cardiothoracicsurgery.org/content/3/1/35 kostenfrei https://doaj.org/toc/1749-8090 Journal toc kostenfrei GBV_USEFLAG_A SYSFLAG_A GBV_DOAJ GBV_ILN_11 GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_2003 GBV_ILN_2005 GBV_ILN_2009 GBV_ILN_2011 GBV_ILN_2014 GBV_ILN_2055 GBV_ILN_2111 GBV_ILN_2522 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 3 2008 1, p 35
spelling	10.1186/1749-8090-3-35 doi (DE-627)DOAJ042760402 (DE-599)DOAJac6109be48cf47529fe2bae7a16f8447 DE-627 ger DE-627 rakwb eng RD1-811 RD78.3-87.3 Parolari Alessandro verfasserin aut Double vs single internal thoracic artery harvesting in diabetic patients: role in perioperative infection rate 2008 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier <p<Abstract</p< <p<Background</p< <p<The aim of this prospective study is to evaluate the role in the onset of surgical site infections of bilateral internal thoracic arteries harvesting in patients with decompensated preoperative glycemia.</p< <p<Methods</p< <p<81 consecutive patients with uncontrolled diabetes mellitus underwent elective CABG harvesting single or double internal thoracic arteries. Single left ITA was harvested in 41 patients (Group 1, 50.6%), BITAs were harvested in 40 (Group 2, 49.4%). The major clinical end points analyzed in this study were infection rate, type of infection, duration of infection, infection relapse rate and total hospital length of stay.</p< <p<Results</p< <p<Five patients developed sternal SSI in the perioperative period, 2 in group 1 and 3 in group 2 without significant difference. All sternal SSIs were superficial with no sternal dehiscence. The development of infection from the time of surgery took 18.5 ± 2.1 and 7.3 ± 3.0 days for Groups 1 and 2 respectively. The infections were treated with wound irrigation and debridement, and with VAC therapy as well as with antibiotics. The VAC system was removed after a mean of 12.8 ± 5.1 days, when sterilization was achieved. The overall survival estimate at 1 year was 98.7%. Only BMI was a significant predictor of SSI using multivariate stepwise logistic regression analysis (Odds Ratio: 1.34; 95%Conficdence Interval: 1.02–1.83; p value: 0.04). In the model, the use of BITA was not an independent predictor of SSI.</p< <p<Conclusion</p< <p<CABG with bilateral pedicled ITAs grafting could be performed safely even in diabetics with poor preoperative glycaemic control.</p< Surgery Anesthesiology Polvani Gianluca verfasserin aut Ghislandi Chiara verfasserin aut Topkara Veli K verfasserin aut Cheema Faisal H verfasserin aut Dainese Luca verfasserin aut Barili Fabio verfasserin aut Trezzi Matteo verfasserin aut Agrifoglio Marco verfasserin aut Alamanni Francesco verfasserin aut Biglioli Paolo verfasserin aut In Journal of Cardiothoracic Surgery BMC, 2006 3(2008), 1, p 35 (DE-627)509401260 (DE-600)2227224-0 17498090 nnns volume:3 year:2008 number:1, p 35 https://doi.org/10.1186/1749-8090-3-35 kostenfrei https://doaj.org/article/ac6109be48cf47529fe2bae7a16f8447 kostenfrei http://www.cardiothoracicsurgery.org/content/3/1/35 kostenfrei https://doaj.org/toc/1749-8090 Journal toc kostenfrei GBV_USEFLAG_A SYSFLAG_A GBV_DOAJ GBV_ILN_11 GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_2003 GBV_ILN_2005 GBV_ILN_2009 GBV_ILN_2011 GBV_ILN_2014 GBV_ILN_2055 GBV_ILN_2111 GBV_ILN_2522 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 3 2008 1, p 35
allfields_unstemmed	10.1186/1749-8090-3-35 doi (DE-627)DOAJ042760402 (DE-599)DOAJac6109be48cf47529fe2bae7a16f8447 DE-627 ger DE-627 rakwb eng RD1-811 RD78.3-87.3 Parolari Alessandro verfasserin aut Double vs single internal thoracic artery harvesting in diabetic patients: role in perioperative infection rate 2008 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier <p<Abstract</p< <p<Background</p< <p<The aim of this prospective study is to evaluate the role in the onset of surgical site infections of bilateral internal thoracic arteries harvesting in patients with decompensated preoperative glycemia.</p< <p<Methods</p< <p<81 consecutive patients with uncontrolled diabetes mellitus underwent elective CABG harvesting single or double internal thoracic arteries. Single left ITA was harvested in 41 patients (Group 1, 50.6%), BITAs were harvested in 40 (Group 2, 49.4%). The major clinical end points analyzed in this study were infection rate, type of infection, duration of infection, infection relapse rate and total hospital length of stay.</p< <p<Results</p< <p<Five patients developed sternal SSI in the perioperative period, 2 in group 1 and 3 in group 2 without significant difference. All sternal SSIs were superficial with no sternal dehiscence. The development of infection from the time of surgery took 18.5 ± 2.1 and 7.3 ± 3.0 days for Groups 1 and 2 respectively. The infections were treated with wound irrigation and debridement, and with VAC therapy as well as with antibiotics. The VAC system was removed after a mean of 12.8 ± 5.1 days, when sterilization was achieved. The overall survival estimate at 1 year was 98.7%. Only BMI was a significant predictor of SSI using multivariate stepwise logistic regression analysis (Odds Ratio: 1.34; 95%Conficdence Interval: 1.02–1.83; p value: 0.04). In the model, the use of BITA was not an independent predictor of SSI.</p< <p<Conclusion</p< <p<CABG with bilateral pedicled ITAs grafting could be performed safely even in diabetics with poor preoperative glycaemic control.</p< Surgery Anesthesiology Polvani Gianluca verfasserin aut Ghislandi Chiara verfasserin aut Topkara Veli K verfasserin aut Cheema Faisal H verfasserin aut Dainese Luca verfasserin aut Barili Fabio verfasserin aut Trezzi Matteo verfasserin aut Agrifoglio Marco verfasserin aut Alamanni Francesco verfasserin aut Biglioli Paolo verfasserin aut In Journal of Cardiothoracic Surgery BMC, 2006 3(2008), 1, p 35 (DE-627)509401260 (DE-600)2227224-0 17498090 nnns volume:3 year:2008 number:1, p 35 https://doi.org/10.1186/1749-8090-3-35 kostenfrei https://doaj.org/article/ac6109be48cf47529fe2bae7a16f8447 kostenfrei http://www.cardiothoracicsurgery.org/content/3/1/35 kostenfrei https://doaj.org/toc/1749-8090 Journal toc kostenfrei GBV_USEFLAG_A SYSFLAG_A GBV_DOAJ GBV_ILN_11 GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_2003 GBV_ILN_2005 GBV_ILN_2009 GBV_ILN_2011 GBV_ILN_2014 GBV_ILN_2055 GBV_ILN_2111 GBV_ILN_2522 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 3 2008 1, p 35
allfieldsGer	10.1186/1749-8090-3-35 doi (DE-627)DOAJ042760402 (DE-599)DOAJac6109be48cf47529fe2bae7a16f8447 DE-627 ger DE-627 rakwb eng RD1-811 RD78.3-87.3 Parolari Alessandro verfasserin aut Double vs single internal thoracic artery harvesting in diabetic patients: role in perioperative infection rate 2008 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier <p<Abstract</p< <p<Background</p< <p<The aim of this prospective study is to evaluate the role in the onset of surgical site infections of bilateral internal thoracic arteries harvesting in patients with decompensated preoperative glycemia.</p< <p<Methods</p< <p<81 consecutive patients with uncontrolled diabetes mellitus underwent elective CABG harvesting single or double internal thoracic arteries. Single left ITA was harvested in 41 patients (Group 1, 50.6%), BITAs were harvested in 40 (Group 2, 49.4%). The major clinical end points analyzed in this study were infection rate, type of infection, duration of infection, infection relapse rate and total hospital length of stay.</p< <p<Results</p< <p<Five patients developed sternal SSI in the perioperative period, 2 in group 1 and 3 in group 2 without significant difference. All sternal SSIs were superficial with no sternal dehiscence. The development of infection from the time of surgery took 18.5 ± 2.1 and 7.3 ± 3.0 days for Groups 1 and 2 respectively. The infections were treated with wound irrigation and debridement, and with VAC therapy as well as with antibiotics. The VAC system was removed after a mean of 12.8 ± 5.1 days, when sterilization was achieved. The overall survival estimate at 1 year was 98.7%. Only BMI was a significant predictor of SSI using multivariate stepwise logistic regression analysis (Odds Ratio: 1.34; 95%Conficdence Interval: 1.02–1.83; p value: 0.04). In the model, the use of BITA was not an independent predictor of SSI.</p< <p<Conclusion</p< <p<CABG with bilateral pedicled ITAs grafting could be performed safely even in diabetics with poor preoperative glycaemic control.</p< Surgery Anesthesiology Polvani Gianluca verfasserin aut Ghislandi Chiara verfasserin aut Topkara Veli K verfasserin aut Cheema Faisal H verfasserin aut Dainese Luca verfasserin aut Barili Fabio verfasserin aut Trezzi Matteo verfasserin aut Agrifoglio Marco verfasserin aut Alamanni Francesco verfasserin aut Biglioli Paolo verfasserin aut In Journal of Cardiothoracic Surgery BMC, 2006 3(2008), 1, p 35 (DE-627)509401260 (DE-600)2227224-0 17498090 nnns volume:3 year:2008 number:1, p 35 https://doi.org/10.1186/1749-8090-3-35 kostenfrei https://doaj.org/article/ac6109be48cf47529fe2bae7a16f8447 kostenfrei http://www.cardiothoracicsurgery.org/content/3/1/35 kostenfrei https://doaj.org/toc/1749-8090 Journal toc kostenfrei GBV_USEFLAG_A SYSFLAG_A GBV_DOAJ GBV_ILN_11 GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_2003 GBV_ILN_2005 GBV_ILN_2009 GBV_ILN_2011 GBV_ILN_2014 GBV_ILN_2055 GBV_ILN_2111 GBV_ILN_2522 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 3 2008 1, p 35
allfieldsSound	10.1186/1749-8090-3-35 doi (DE-627)DOAJ042760402 (DE-599)DOAJac6109be48cf47529fe2bae7a16f8447 DE-627 ger DE-627 rakwb eng RD1-811 RD78.3-87.3 Parolari Alessandro verfasserin aut Double vs single internal thoracic artery harvesting in diabetic patients: role in perioperative infection rate 2008 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier <p<Abstract</p< <p<Background</p< <p<The aim of this prospective study is to evaluate the role in the onset of surgical site infections of bilateral internal thoracic arteries harvesting in patients with decompensated preoperative glycemia.</p< <p<Methods</p< <p<81 consecutive patients with uncontrolled diabetes mellitus underwent elective CABG harvesting single or double internal thoracic arteries. Single left ITA was harvested in 41 patients (Group 1, 50.6%), BITAs were harvested in 40 (Group 2, 49.4%). The major clinical end points analyzed in this study were infection rate, type of infection, duration of infection, infection relapse rate and total hospital length of stay.</p< <p<Results</p< <p<Five patients developed sternal SSI in the perioperative period, 2 in group 1 and 3 in group 2 without significant difference. All sternal SSIs were superficial with no sternal dehiscence. The development of infection from the time of surgery took 18.5 ± 2.1 and 7.3 ± 3.0 days for Groups 1 and 2 respectively. The infections were treated with wound irrigation and debridement, and with VAC therapy as well as with antibiotics. The VAC system was removed after a mean of 12.8 ± 5.1 days, when sterilization was achieved. The overall survival estimate at 1 year was 98.7%. Only BMI was a significant predictor of SSI using multivariate stepwise logistic regression analysis (Odds Ratio: 1.34; 95%Conficdence Interval: 1.02–1.83; p value: 0.04). In the model, the use of BITA was not an independent predictor of SSI.</p< <p<Conclusion</p< <p<CABG with bilateral pedicled ITAs grafting could be performed safely even in diabetics with poor preoperative glycaemic control.</p< Surgery Anesthesiology Polvani Gianluca verfasserin aut Ghislandi Chiara verfasserin aut Topkara Veli K verfasserin aut Cheema Faisal H verfasserin aut Dainese Luca verfasserin aut Barili Fabio verfasserin aut Trezzi Matteo verfasserin aut Agrifoglio Marco verfasserin aut Alamanni Francesco verfasserin aut Biglioli Paolo verfasserin aut In Journal of Cardiothoracic Surgery BMC, 2006 3(2008), 1, p 35 (DE-627)509401260 (DE-600)2227224-0 17498090 nnns volume:3 year:2008 number:1, p 35 https://doi.org/10.1186/1749-8090-3-35 kostenfrei https://doaj.org/article/ac6109be48cf47529fe2bae7a16f8447 kostenfrei http://www.cardiothoracicsurgery.org/content/3/1/35 kostenfrei https://doaj.org/toc/1749-8090 Journal toc kostenfrei GBV_USEFLAG_A SYSFLAG_A GBV_DOAJ GBV_ILN_11 GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_2003 GBV_ILN_2005 GBV_ILN_2009 GBV_ILN_2011 GBV_ILN_2014 GBV_ILN_2055 GBV_ILN_2111 GBV_ILN_2522 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 3 2008 1, p 35
language	English
source	In Journal of Cardiothoracic Surgery 3(2008), 1, p 35 volume:3 year:2008 number:1, p 35
sourceStr	In Journal of Cardiothoracic Surgery 3(2008), 1, p 35 volume:3 year:2008 number:1, p 35
format_phy_str_mv	Article
institution	findex.gbv.de
topic_facet	Surgery Anesthesiology
isfreeaccess_bool	true
container_title	Journal of Cardiothoracic Surgery
authorswithroles_txt_mv	Parolari Alessandro @@aut@@ Polvani Gianluca @@aut@@ Ghislandi Chiara @@aut@@ Topkara Veli K @@aut@@ Cheema Faisal H @@aut@@ Dainese Luca @@aut@@ Barili Fabio @@aut@@ Trezzi Matteo @@aut@@ Agrifoglio Marco @@aut@@ Alamanni Francesco @@aut@@ Biglioli Paolo @@aut@@
publishDateDaySort_date	2008-01-01T00:00:00Z
hierarchy_top_id	509401260
id	DOAJ042760402
language_de	englisch
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callnumber-first	R - Medicine
author	Parolari Alessandro
spellingShingle	Parolari Alessandro misc RD1-811 misc RD78.3-87.3 misc Surgery misc Anesthesiology Double vs single internal thoracic artery harvesting in diabetic patients: role in perioperative infection rate
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topic_title	RD1-811 RD78.3-87.3 Double vs single internal thoracic artery harvesting in diabetic patients: role in perioperative infection rate
topic	misc RD1-811 misc RD78.3-87.3 misc Surgery misc Anesthesiology
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title	Double vs single internal thoracic artery harvesting in diabetic patients: role in perioperative infection rate
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title_full	Double vs single internal thoracic artery harvesting in diabetic patients: role in perioperative infection rate
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author_browse	Parolari Alessandro Polvani Gianluca Ghislandi Chiara Topkara Veli K Cheema Faisal H Dainese Luca Barili Fabio Trezzi Matteo Agrifoglio Marco Alamanni Francesco Biglioli Paolo
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title_sort	double vs single internal thoracic artery harvesting in diabetic patients: role in perioperative infection rate
callnumber	RD1-811
title_auth	Double vs single internal thoracic artery harvesting in diabetic patients: role in perioperative infection rate
abstract	<p<Abstract</p< <p<Background</p< <p<The aim of this prospective study is to evaluate the role in the onset of surgical site infections of bilateral internal thoracic arteries harvesting in patients with decompensated preoperative glycemia.</p< <p<Methods</p< <p<81 consecutive patients with uncontrolled diabetes mellitus underwent elective CABG harvesting single or double internal thoracic arteries. Single left ITA was harvested in 41 patients (Group 1, 50.6%), BITAs were harvested in 40 (Group 2, 49.4%). The major clinical end points analyzed in this study were infection rate, type of infection, duration of infection, infection relapse rate and total hospital length of stay.</p< <p<Results</p< <p<Five patients developed sternal SSI in the perioperative period, 2 in group 1 and 3 in group 2 without significant difference. All sternal SSIs were superficial with no sternal dehiscence. The development of infection from the time of surgery took 18.5 ± 2.1 and 7.3 ± 3.0 days for Groups 1 and 2 respectively. The infections were treated with wound irrigation and debridement, and with VAC therapy as well as with antibiotics. The VAC system was removed after a mean of 12.8 ± 5.1 days, when sterilization was achieved. The overall survival estimate at 1 year was 98.7%. Only BMI was a significant predictor of SSI using multivariate stepwise logistic regression analysis (Odds Ratio: 1.34; 95%Conficdence Interval: 1.02–1.83; p value: 0.04). In the model, the use of BITA was not an independent predictor of SSI.</p< <p<Conclusion</p< <p<CABG with bilateral pedicled ITAs grafting could be performed safely even in diabetics with poor preoperative glycaemic control.</p<
abstractGer	<p<Abstract</p< <p<Background</p< <p<The aim of this prospective study is to evaluate the role in the onset of surgical site infections of bilateral internal thoracic arteries harvesting in patients with decompensated preoperative glycemia.</p< <p<Methods</p< <p<81 consecutive patients with uncontrolled diabetes mellitus underwent elective CABG harvesting single or double internal thoracic arteries. Single left ITA was harvested in 41 patients (Group 1, 50.6%), BITAs were harvested in 40 (Group 2, 49.4%). The major clinical end points analyzed in this study were infection rate, type of infection, duration of infection, infection relapse rate and total hospital length of stay.</p< <p<Results</p< <p<Five patients developed sternal SSI in the perioperative period, 2 in group 1 and 3 in group 2 without significant difference. All sternal SSIs were superficial with no sternal dehiscence. The development of infection from the time of surgery took 18.5 ± 2.1 and 7.3 ± 3.0 days for Groups 1 and 2 respectively. The infections were treated with wound irrigation and debridement, and with VAC therapy as well as with antibiotics. The VAC system was removed after a mean of 12.8 ± 5.1 days, when sterilization was achieved. The overall survival estimate at 1 year was 98.7%. Only BMI was a significant predictor of SSI using multivariate stepwise logistic regression analysis (Odds Ratio: 1.34; 95%Conficdence Interval: 1.02–1.83; p value: 0.04). In the model, the use of BITA was not an independent predictor of SSI.</p< <p<Conclusion</p< <p<CABG with bilateral pedicled ITAs grafting could be performed safely even in diabetics with poor preoperative glycaemic control.</p<
abstract_unstemmed	<p<Abstract</p< <p<Background</p< <p<The aim of this prospective study is to evaluate the role in the onset of surgical site infections of bilateral internal thoracic arteries harvesting in patients with decompensated preoperative glycemia.</p< <p<Methods</p< <p<81 consecutive patients with uncontrolled diabetes mellitus underwent elective CABG harvesting single or double internal thoracic arteries. Single left ITA was harvested in 41 patients (Group 1, 50.6%), BITAs were harvested in 40 (Group 2, 49.4%). The major clinical end points analyzed in this study were infection rate, type of infection, duration of infection, infection relapse rate and total hospital length of stay.</p< <p<Results</p< <p<Five patients developed sternal SSI in the perioperative period, 2 in group 1 and 3 in group 2 without significant difference. All sternal SSIs were superficial with no sternal dehiscence. The development of infection from the time of surgery took 18.5 ± 2.1 and 7.3 ± 3.0 days for Groups 1 and 2 respectively. The infections were treated with wound irrigation and debridement, and with VAC therapy as well as with antibiotics. The VAC system was removed after a mean of 12.8 ± 5.1 days, when sterilization was achieved. The overall survival estimate at 1 year was 98.7%. Only BMI was a significant predictor of SSI using multivariate stepwise logistic regression analysis (Odds Ratio: 1.34; 95%Conficdence Interval: 1.02–1.83; p value: 0.04). In the model, the use of BITA was not an independent predictor of SSI.</p< <p<Conclusion</p< <p<CABG with bilateral pedicled ITAs grafting could be performed safely even in diabetics with poor preoperative glycaemic control.</p<
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title_short	Double vs single internal thoracic artery harvesting in diabetic patients: role in perioperative infection rate
url	https://doi.org/10.1186/1749-8090-3-35 https://doaj.org/article/ac6109be48cf47529fe2bae7a16f8447 http://www.cardiothoracicsurgery.org/content/3/1/35 https://doaj.org/toc/1749-8090
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score	7.400014

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Double vs single internal thoracic artery harvesting in diabetic patients: role in perioperative infection rate

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