Deep sternal wound infection and mediastinitis are infrequent but serious complications following median sternotomy for open heart surgery. These infections are associated with significant morbidity and mortality. The presence of risk factors can help identify a patient who is more likely to experience a significant post-operative infection.
Incidence of serious infection is less than 1%:
(1) 0.40% of 4,043 patients (El Oakley, 1997)
(2) 0.75% of 12,267 patients (Borger)
Risk factors following median sternotomy:
(1) diabetes mellitus
(2) obesity (body weight > 120% of normal weight for height and gender)
(3) immunosuppression
(4) the need for 3 or more units of blood transfusion in the early postoperative period.
(5) re-sternotomy for bleeding
(6) prolonged operative time
(7) male gender
Risk factors in patients undergoing coronary artery bypass grafts (CABG):
(8) bilateral internal thoracic (mammary) artery grafts in the presence of diabetes
(9) associated leg wound infections
Other risk factors reported (El Oakley, 1996, page 1032):
(1) advanced age
(2) previous mediastinal radiation
(3) type of cardiac operation
(4) prolonged post-operative mechanical ventilation
