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Defining post-sternotomy mediastinitis for clinical evidence-based studies.

Jan J van Wingerden1, Bas A J M de Mol2, Chantal M A M van der Horst3

  • 1Department of Plastic and Reconstructive Surgery, Academic Medical Center, University of Amsterdam, The Netherlands j.j.vanwingerden@amc.uva.nl.

Asian Cardiovascular & Thoracic Annals
|March 13, 2016
PubMed
Summary

Clinicians lack a single definition for post-sternotomy infections, hindering evidence-based studies. A standardized term and clinical definition are proposed to improve diagnosis and treatment of these deep thoracic wound infections.

Keywords:
MediastinitisMediastinumSternotomySurgical wound infection

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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.