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A review of the AATS guidelines for the prevention and management of sternal wound infections

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Indian Journal of Thoracic and Cardiovascular Surgery Aims and scope Submit manuscript

Abstract

Purpose

To summarize the AATS guidelines for the prevention and treatment of sternal wound infections.

Methods

The current AATS guidelines for the prevention of sternal wound infections during the preoperative, intraoperative, and postoperative periods, and the most effective methods and techniques to treat sternal wound infections were reviewed.

Results

The guidelines identified multiple interventions that can be instituted during the preoperative, intraoperative, and postoperative periods to reduce sternal wound infections during cardiac surgery. These include the use of perioperative antibiotics, glycemic control to maintain serum glucose < 180 mg/dl, avoidance of bone wax and the use of vancomycin paste to the sternal edges, and figure of eight suture techniques to re-approximate the sternum. Wound Vac therapy should be instituted whenever possible to treat and enhance recovery from mediastinitis.

Conclusions

The prevention of sternal wound infections and mediastinitis can be achieved by adherence to the AATS guidelines. The institution of these interventions requires a multi-disciplinary team effort among surgeons, anesthesiologists, referring physicians, nurses, and OR and ICU personnel.

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Authors and Affiliations

  1. From the Division of Cardiac Surgery, The Boston University School of Medicine, 80 East Concord Street, Boston, MA, 02118, USA

    Harold L. Lazar

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  1. Harold L. Lazar
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Correspondence to Harold L. Lazar.

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The author declares that he has no conflict of interest.

Ethical approval, Statement of Human and Animal Rights, Informed consent--Being a Review article, these are not required.

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Lazar, H.L. A review of the AATS guidelines for the prevention and management of sternal wound infections. Indian J Thorac Cardiovasc Surg 34 (Suppl 3), 349–354 (2018). https://doi.org/10.1007/s12055-018-0686-3

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  • DOI: https://doi.org/10.1007/s12055-018-0686-3

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