The predictors of surgical site infection post cardiac surgery: A systematic review

We sought to conduct a systematic review to evaluate the predictors of surgical site infection (SSI) after cardiac surgery. We included published, peer-reviewed, English-language, retrospective and prospective studies identified in a search of Medline, CINAHL, and PubMed from 2005 and through February 20, 2012. The studies involved adults (age > 18 years) undergoing cardiac surgery (defined by ICD-9 codes) and could be of any study design, in English, published within last 7 years, with data collection taking place in United States within last 10 years. We excluded animal studies, duplicates, summaries, commentaries, editorials, case reports, studies that conducted outside United States, and studies published before last 7 years or studies with data collection take place before last 10 years (2002). Three types of predictors emerge: Predictors of general infection post cardiac surgery, predictors of micro-organisms' specific SSIs and tracheotomy, and allogenic blood transfusion as specific predictors of SSI. Although the reviewed articles cover wide range of SSIs predictors, none of these articles investigate preoperative skin preparation, using pre-and postoperative prophylaxes antibiotics, postoperative wound care (appropriate time for first dressing), and patient nutritional status as a predictors of SSIs after cardiac surgery. Investigating these predictors for SSIs will enhance nurses' understanding of the importance of specific types of nutrition in preventing SSIs and enhancing wound healing, implementing a protocol for the wound care postoperatively, and implementing a protocol for the use of prophylactic antibiotics.