Diagnosis of poststernotomy infection: comparison of three means of assessment

Of 737 adults undergoing cardiac operations through a median sternotomy over a 2-year period (January 1988 to January 1990), sternal-substernal space infection requiring mediastinal exploration developed in 8. Six of these patients as well as 18 additional patients were evaluated for possible poststernotomy wound infection by computed tomography (4 true positive, 4 false positive, 10 true negative, 2 false negative), indium-111 leukocyte scanning (5 true positive, 0 false positive, 18 true negative, 1 false negative), and epicardial pacer wire cultures (6 true positive, 1 false positive, 12 true negative, 0 false negative). On the basis of this experience it is suggested that in addition to computed tomography, indium-111 leukocyte scanning and epicardial pacer wire cultures may be useful in the diagnosis of poststernotomy deep wound infection.