Purpose: We sought to determine whether long duration of delayed sternal closure (DSC) increases the risk of sternal wound infection (SWI) or wound dehiscence (WD) in patients with congenital heart disease. Methods: Retrospective review of 154 patients with DSC, who had undergone procedures for congenital heart disease between January 1999 and April 2009, was performed. During the same time frame, 6253 congenital heart surgery were performed. Thus, 2.46 % of patients (154 / 6253) had DSC. Median body weight and age at operation were 3.6 kg (1.5 - 80 kg) and 25 days (2 days - 20 years),respectively. Palliative procedures were performed in 58 patients (37.7%). Multivariable analysis was conducted to identify risk factors for SWI or WD, including preoperative and intra-operative variables( sex, age at operation, body weight, cardiopulmonary bypass time, duration of sternal opening, palliative procedures, comprehensive Aristotle score, ICU stay days, Ventilatory support days). Mean comprehensive Aristotle score was 13.2 ± 3.1 (6-23). Results: There were 28 hospital mortalities (28/154, 18.2%). Excluding patients who died before sternal closure (4/154, 2.6%), median duration of the sternal opening was 3.5 days (1 – 182 days) and SWI / WD occurred in 31 patients (31/150, 20.6%). Univariate analysis revealed that the duration of the sternal opening, comprehensive Aristotle score and ventilatory support days were risk factors for SWI or WD (p<0.05). After adjustment, comprehensive Aristotle score and ventilatory support days were were risk factors for SWI or WD (p<0.05). Duration of the sternal opening (p=0.11) was not identified as a risk factor for SWI or WD. Conclusions: Long duration of the sternal opening is not risk factor of sternal wound infection or wound dehiscence.
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