Prevention of mediastinitis

Sternal wound infections resulting in mediastinitis following coronary artery bypass graft surgery increase morbidity, prolong hospital length of stay, raise hospital costs, and increase both short- and long-term mortality. The increased risk for sternal infections has discouraged the use of bilateral internal thoracic artery grafts, especially in diabetic patients. This chapter reviews the preoperative, intraoperative, and postoperative principles for preventing sternal wound infections and mediastinitis following coronary artery bypass graft surgery.