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Background: The rate and risk factors for surgical site infections (SSIs) in pediatric cardiac patients have not been well delineated.

Methods: All patients aged <18 years who had open-heart surgery at the Stollery Children's Hospital in the 1998-2002 period were followed. A case-control study was performed to examine risk factors for SSI. Controls were matched to cases according to National Nosocomial Surveillance System risk scores, age, and year of surgery.

Results: SSI incidence was 3.4% (0.9% superficial wound infections, .1% deep incisional surgical site infections, and 2.4% organ space surgical site infections). In the case-control study, the only risk factor that was statistically significant was the duration of surgery. There was a trend toward an increased incidence of SSI (P < .25) for children with failure to thrive, or for those who required inotropes or had an elevated serum lactate in the first 24 hours postoperation.

Conclusion: In pediatric cardiac surgery, the risk of SSI increases with the duration of surgery. There is a need for prospective studies of potentially modifiable risk factors.