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Preventing infection in open heart surgery.

The risks for infection following open heart surgery may be divided into three components: the environment, operating room personnel, and the patient. Critical appraisal of the available literature yields the following conclusions. First, the environment may result in fungal or bacterial contamination of the surgical wound or mucosal surfaces. However, it is infrequently possible to prove that such contamination causes infections. Second, personnel may contaminate the patients, but rarely do so. Third, the patient's endogenous flora is most often the source of infecting bacteria. Proper preoperative preparation and judicious use of prophylactic antibiotics minimize the risk of infection.