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Sternal wound infections

P L Vaska

    AACN Clinical Issues in Critical Care Nursing
    |August 1, 1993
    PubMed
    Summary

    Sternal wound infections after cardiac surgery are serious complications. Prompt surgical debridement and antibiotic therapy are crucial for treating these infections and improving patient outcomes.

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    Area of Science:

    • Cardiovascular Surgery
    • Infectious Diseases
    • Surgical Site Infections

    Background:

    • Sternal wound infections are significant causes of morbidity and mortality following cardiac surgery.
    • These infections occur in 1-3% of open-heart surgery patients, with a 20-40% mortality rate.
    • Infections range from superficial to deep mediastinitis, often caused by Staphylococcus species.

    Purpose of the Study:

    • To summarize the epidemiology, risk factors, clinical presentation, and management of sternal wound infections.
    • To highlight the importance of early diagnosis and appropriate treatment strategies.

    Main Methods:

    • Review of existing literature on sternal wound infections post-cardiac surgery.
    • Analysis of common causative organisms, risk factors, and clinical manifestations.
    • Overview of current treatment modalities, including surgical and antibiotic approaches.

    Main Results:

    • Key signs and symptoms include fever, leukocytosis, sternal instability, drainage, and pain.
    • Bilateral internal mammary artery bypass grafting in diabetic patients is a primary risk factor.
    • Treatment involves surgical debridement and antibiotic therapy.

    Conclusions:

    • Sternal wound infections necessitate aggressive management, including surgical intervention and antibiotics.
    • Preventive measures and prompt treatment are vital to reduce associated mortality and morbidity.
    • Further research into simple preventive procedures could benefit high-risk patients.

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