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Surgical site infection
Wound infections

Sternal wound infections after sternotomy: risk factors, prevention and management

01 June 2022
Practice

Abstract

A serious complication after cardiac surgery is sternal wound infection. Although incidence rates vary worldwide, this complication raises significant concern in a certain patient demographic. This article uses risk assessment strategies to identify a high-risk patient profile and draws parallels with positive predictors in the preoperative, intraoperative and postoperative setting. It describes the complexity of sternal wound infections and highlights guidelines on detection and treatment. The optimal goal of this article is to help minimise the incidence of sternal wound complications after sternotomy by discussing recommendations for preoperative, intraoperative and postoperative preventive measures.

Sternal wound infections (SWI) remain a challenging problem in patients after median sternotomy. Sternotomy complications can potentially range from a superficial SWI with minor skin dehiscence, with or without abscess, to deep SWI with deep fascia involvement, sternal instability and life-threatening mediastinitis.1 According to data presented by the National Society of Thoracic Surgeons (STS), the prevalence of superficial SWI varies widely from 1.6% in elective patients with low risk factors to 6.4% in patients with high risk factors. The rate of deep SWI is reported to be 0.2–3.0%.2,3 Complications after sternotomies lead to prolonged hospital stay and elevated levels of readmission, they affect morbidity and mortality rates, reduce a patient's quality of life and escalate overall financial costs. Prevention of SWI is one of the most significant concerns facing health professionals.4

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cardiac surgery
risk factors for sternal wound infections
sternal complications
sternal wound infections
sternotomy
surgical site infections
treatment
wound
wound care
wound healing
wound infection