Acute Mediastinitis
ICD-10 J98.5 · ICD-11 CB22.Z

Treatment of Acute Mediastinitis with Deep Sternal Wound Infection Following Median Sternotomy

Mediastinitis and deep sternal wound infection (DSWI) are devastating and life-threatening complications that may arise after median sternotomy, typically presenting within 30 days of cardiac surgery.

Clinical Scenario

This protocol applies to patients with deep sternal wound infection following median sternotomy presenting with purulent drainage from the sternal wound, sternal instability, and fever.

Approach

Management is surgical and is tailored to the structural state of the sternum — the complete decision framework and reconstruction options are available in the full protocol.

Instant Access to Structured Evidence-Based Regimens

References

DOI: 10.1093/ejcts/ezw326

  • Mediastinitis and deep sternal wound infection (DSWI) are devastating and life-threatening complications after median sternotomy.
  • Signs and symptoms of mediastinitis typically present within 30 days of cardiac surgery.
  • Local signs include purulent drainage from the sternal wound and sternal instability.
  • The use of muscle or omental flap in case of sternal instability or insufficient bone stock may be considered.
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