Re: Negative microbiological results are not mandatory in deep sternal wound infections before wound closure

Deep sternal wound infection (DSWI) is a serious complication of cardiac surgery with high additional morbidity and mortality. The incidence is less than 1%, but associated with mortality rates between 14 and 47 % [1]. There are multiple predisposing factors ranging from patient-risk factors (i.e. obesity, chronic obstructive pulmonary disease, advanced age, male sex), perioperative patient management (i.e. antibiotic prophylaxis, hair removal, blood transfusion, ventilation time) and the surgical procedure itself. The most important aspect in the treatment of DSWI is to prevent it. Basic surgical rules, like sterility during the procedure, should be taken for granted. A further prophylactic treatment has recently been described by Schimmer et al. [2]. They reported a significant reduction of sternal wound complications after genta-micin–collagen sponge application before chest closure in a con-trolled, prospectively randomized, double-blind study