Continuing Education through JHQ

Cardiac surgery is performed on more than 600,000 patients in the United States yearly (American Heart Association, 2001; McConkey et al., 1999). Postoperative mediastinitis is one of the devastating complications of this procedure. The reported incidence ranges from a fraction of a percentage to more than 2 % for all cardiac surgery operations in the United States (Bitkover & Gardlund, 1998; Borger et al., 1998). Mediastinitis develops as a result of a complex interaction of patient, surgical, and virulent microbial risk factors. Major consequences include at least two additional operations; increased morbidity and mortality, with extended hospitalization of an average 30 days; and significant economic loss, ranging from $20,000 to $60,000 as direct attributable costs per infected patient (Gaynes et al., 1991