Current perspectives on diagnosis and management of sternal wound infections

Abstract

Current perspectives on diagnosis and management of sternal wound infections Erlangga Yusuf,1 Monica Chan,2 Nora Renz,3 Andrej Trampuz3 1Department of Medical Microbiology, Antwerp University Hospital (UZA), University of Antwerp, Antwerp, Belgium; 2Department of Infectious Diseases, Tan Tock Seng Hospital, Singapore; 3Charité Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Center for Musculoskeletal Surgery (CMSC), Berlin, Germany Abstract: Deep sternal wound infection (DSWI), also known as mediastinitis, is a serious and potentially fatal condition. The diagnosis and treatment of DSWI are challenging. In this current narrative review, the epidemiology, risk factors, diagnosis, and surgical and antimicrobial management of DSWI are discussed. Ideally, the management of DSWI requires early and sufficient surgical debridement and appropriate antibiotic therapy. When foreign material is present, biofilm-active antibiotic therapy is also needed. Because DSWI is often complex, the management requires the involvement of a multidisciplinary team consisting of cardiothoracic surgeons, plastic surgeons, intensivists, infectious disease specialists, and clinical microbiologists. Keywords: deep sternal wound infection, diagnosis, antibiotic, surgical treatment