Introduction
The historical incidence of deep sternal wound infection (DSWI) after
sternotomy for cardiac surgery ranges between 0.2 and 8%, with most
recent estimates demonstrating a persistent risk despite implementation
of quality improvement initiatives of 1-2%[1-4]. Although
relatively uncommon, this complication is associated with increased
duration of hospital stay or readmission, mortality, significant
morbidity and costs[5,6].
Management options for deep sternal wound infection are typically
individualized based on the extent of infection, offending organisms,
and clinical status of the patient. Treatment can include combinations
of antibiotic therapy, wound debridement, negative pressure wound
therapy, partial or total sternal resection, and soft tissue flap
reconstruction[7-11]. The optimal treatment for these infections
remains controversial and highly individualized based on surgeon and
treatment center[7]. Although a multitude of risk factors for deep
sternal wound infection have been identified, the timing of onset of
infection as a risk factor for mortality is not well characterized. The
present study examined outcomes for deep sternal wound infection after
cardiac surgery based on the time of onset.