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Updated: Jan 29, 2026
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Author Spotlight: Studying Host-Microbe Interactions in Wound Biofilm Formation
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Osteomyelitis in Deep Sternal Wound Infections: Revisited-A Single-Center Observational Study
Stephan Raab1, Tina Schaller2, Evaldas Girdauskas1
1Clinic of Cardiothoracic Surgery, University Hospital Augsburg, Faculty of Medicine, University of Augsburg, 86156 Augsburg, Germany.
Life (Basel, Switzerland)
|January 28, 2026
Summary
Deep sternal wound infection (DSWI) and sternum osteomyelitis are distinct conditions. Prompt histopathological detection of osteomyelitis in DSWI patients is crucial for effective long-term antibiotic therapy and improved outcomes.
Area of Science:
- Cardiovascular Surgery
- Infectious Diseases
- Orthopedic Surgery
Background:
- Deep sternal wound infection (DSWI) following cardiac surgery is a serious complication.
- DSWI is often conflated with sternum osteomyelitis, potentially impacting treatment strategies.
Purpose of the Study:
- To determine the prevalence of osteomyelitis in patients with DSWI after cardiac surgery.
- To evaluate the impact of osteomyelitis on DSWI treatment and sternal reconstruction outcomes.
Main Methods:
- Retrospective observational study of 130 cardiac surgery patients with DSWI (2014-2019).
- Inclusion criteria: DSWI post-sternotomy. Interventions: Wound reopening, material removal, negative pressure therapy, microbiological swabs, and bone biopsy for osteomyelitis detection.
- Long-term antibiotics administered for confirmed osteomyelitis.
Main Results:
- Osteomyelitis was histopathologically confirmed in 77% (102/130) of DSWI patients.
- Lower frequency of transverse sternal fractures in the osteomyelitis subgroup (63%) vs. non-osteomyelitis subgroup (93%).
- Pathogens detected in all osteomyelitis cases vs. 64% in non-osteomyelitis cases. No difference in reinfection rates after sternal restabilization with long-term antibiotics.
Conclusions:
- Deep sternal wound infection (DSWI) and sternum osteomyelitis are not interchangeable clinical entities.
- Histopathological diagnosis of osteomyelitis necessitates consistent long-term antibiotic treatment.
- Secure primary sternal fixation is essential to mitigate risks associated with DSWI, irrespective of osteomyelitis presence.
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