Sternal and costochondral infections following open-heart surgery. A review of 2,594 cases

From a series of 2,594 patients undergoing open-heart surgery, 39 had sternal or costochondral infections. Most of these infections were associated with a number of predisposing factors: prolonged perfusion time, excessive postoperative bleeding, depressed cardiac output in the postoperative period, and a history of re-exploration for the control of hemorrhage. One important factor was the use of bilateral internal mammary artery implants. The prognosis for patients with sternal wound infections appears related to the length of time required for institution of treatment and the adequacy of initial therapy. Most of these infections are caused by staphylococcus, although the more complicated infections often are caused by fungus. The prevention of serious sternal infections depends on a combination of proper preoperative preparation, attention to minute details at the time of operation, and recognition of variables predisposing to wound complications.