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

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. © Indian Association of Cardiovascular-Thoracic Surgeons 2018.