Surgical site infection (SSI) after cardiac surgery — particularly deep sternal wound infection and mediastinitis — is an uncommon but serious complication associated with prolonged hospitalization and significant morbidity. Prevention relies on a bundle of evidence-based measures spanning the entire perioperative period rather than any single intervention.
Preoperative measures
- Screening and decolonization for nasal carriage reduces the reservoir of skin flora.
- Glycemic optimization before surgery addresses a major modifiable risk factor.
- Skin antisepsis and appropriate hair removal prepare the operative field.
- Timely, weight-appropriate antibiotic prophylaxis ensures tissue levels at incision.
Intraoperative measures
Meticulous sternal closure technique, maintenance of normothermia, judicious use of bone wax, and careful hemostasis all reduce risk. Rigid sternal fixation in high-risk patients and attention to graft harvesting technique contribute to wound stability and healing.
Postoperative measures
Continued glucose control, early identification of wound problems, and structured wound care are central. Negative-pressure wound therapy over closed incisions is used in selected high-risk patients to support healing.
A bundle approach
The strongest results come from consistently applying the full bundle rather than isolated steps. Institutional protocols, checklists, and surveillance with feedback sustain adherence and allow teams to track and reduce infection rates over time.
INVAMED technologies in this space
INVAMED manufactures cardiac surgery instruments including sternal fixation systems; explore the cardiac surgery instruments category.
Device availability and approved indications vary by country. This content is prepared for healthcare professionals and does not replace clinical judgment or the instructions for use.