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.