Deep Sternal Wound Infection: Diagnosis, Treatment and Prevention

J Cardiothorac Vasc Anesth. 2020 Jun;34(6):1602-1613. doi: 10.1053/j.jvca.2019.09.019. Epub 2019 Sep 18.

Abstract

Deep sternal wound infection (DSWI) is a rare but potentially devastating complication of median sternotomy performed in cardiac surgery. The incidence of DSWI is reported to be between 0.2% and 3%. Identifying high-risk patients and strategies to optimize risk factors plays an important role in reducing the incidence of DSWI. Management of DSWI can be complex and may require a multidisciplinary team approach involving infectious disease specialists, microbiologists, as well as cardiothoracic and plastic surgeons. Early detection, appropriate antibiotic treatment, aggressive surgical debridement, and use of regional muscle flaps have significantly improved treatment outcomes.

Keywords: cardiac surgery; management of mediastinitis; prevention; sternal instability; treatment; wound dehiscence.

Publication types

  • Review

MeSH terms

  • Cardiac Surgical Procedures* / adverse effects
  • Humans
  • Retrospective Studies
  • Risk Factors
  • Sternotomy / adverse effects
  • Sternum / surgery
  • Surgical Flaps
  • Surgical Wound Infection* / diagnosis
  • Surgical Wound Infection* / prevention & control