Defining post-sternotomy mediastinitis for clinical evidence-based studies

Area of Science:

• Medical research
• Infectious disease
• Surgical outcomes

Background:

• Deep thoracic wound infections after median sternotomy are a significant concern in cardiac surgery.
• Multidisciplinary team approaches and clear communication are crucial for improving diagnosis, treatment, and outcomes.
• Standardized evidence-based studies and guidelines are needed to overcome existing barriers.

Purpose of the Study:

• To examine the various definitions and classifications of post-sternotomy mediastinitis in the literature.
• To identify inconsistencies in terminology used to describe post-sternotomy infections.
• To propose a standardized definition for thoracic infections following sternotomy.

Main Methods:

• An extensive literature search was conducted across PubMed, EMBASE, and Web of Science (1988-2014).
• Manual searches of reference lists were performed for relevant studies.
• 218 papers describing post-sternotomy infections were analyzed for definitions and terms.

Main Results:

• Clinicians utilize a multitude of terms for post-sternotomy infections without consistent definitions.
• Older epidemiological definitions are occasionally employed.
• Supportive disciplines often have unique definitions or interpretations of existing terms.

Conclusions:

• The lack of a single, adopted definition for post-sternotomy infections impedes evidence-based research.
• A single, standardized term for thoracic infection after sternotomy is feasible.
• A clinical definition is proposed to facilitate future studies and improve patient care.