Deep wound infection on the sternum after open-heart surgery

Abstract

Open-heart surgery is usually performed through median sternotomy, as first described by Milton in 1897. A rare but serious complication associated with this approach is the development of a deep sternal wound infection (DSWI), which has a 4% incidence of occurrence after cardiac surgery. The development of a sternal wound infection often has a late onset and is usually detected only after discharge. DSWI can cause a high morbidity rate of up to 50%, with a prolonged hospital stay and an increased cost of care. In acute stages, sternal collapse and deep mediastinitis can often result in a functional disorder of the organ, which, if not treated adequately, may lead to the patient’s death. Chronic infections are usually associated with chronic draining sinus tracts, osteomyelitis, and costochondritis, which can affect the patient’s quality of life. Early detection and aggressive treatment with debridement, drainage, and immediate wound closure using various muscle flaps are necessary to prevent the development of sternal wound infection. Sternal stability is also an important factor in surgery.