The Role of Microcirculation in the Prevention and Treatment of Post-sternotomy Mediastinitis

Abstract

Median sternotomy remains the standard surgical approach for cardiac surgery, despite the growing popularity of minimal access approaches. Median sternotomy has many advantages; it is simple, quick to perform, and provides wide access to almost all mediastinal structures. However, a major disadvantage of the median sternotomy incision is its suboptimal healing tendency. Infection of sternal wounds remains a major surgical challenge that has a significant impact on morbidity, mortality, hospital costs, long-term survival, and patient’s socio-psychological state. Deep sternal wound infections are rare, with an incidence rate, depending on the definition used, of between 0.4% and 5%, and higher in-hospital mortality rate (7- 35%).