Wound Healing Complications After Sternotomy—Causes, Prevention, and Treatment—A New Look at an Old Problem

Abstract

Median sternotomy is one of the most common procedures in cardiac surgery. This corresponds to the relatively high frequency of infections where surgical incisions are performed. In the prevention of healing disorders, the medical staff intervention is important, as is the patient. The management of wound infection after sternotomy requires a holistic approach. It requires the implementation of adequate antibiotic therapy, surgical treatment of the wound, and, if necessary, reconstruction of tissue defects using skin, muscle, and skin–muscle grafts or greater omentum. The prevention of surgical site infection should be based on asepsis and antisepsis at every stage of surgical treatment; the elimination of modifiable risk factors; and an appropriate, staged, and tension-free technique of chest closure. The described actions are aimed at avoiding the most serious complication associated with a high mortality rate in the form of mediastinitis. The therapeutic procedures are strictly dependent on the degree of tissue involvement and the presented clinical manifestation. During the preparation of this manuscript, scientific publications available on the Pubmed platform were analyzed. The scope of the search was limited to the years 2014–2024. The key words were “sternotomy wound infection”. A total of 114 publications were analyzed, and 56 of them were included. A total of 23 papers were used to discuss the topic.