Cardiac surgery, including coronary artery bypass grafting (CABG) and heart valve surgery, requires careful postoperative wound management. A cardiac surgical site infection (SSI) can delay recovery, increase hospital stays and, in severe cases, lead to complications such as deep sternal wound infection or mediastinitis.

Early detection, appropriate treatment and effective wound care are essential to reduce these risks.

What Causes Cardiac Surgical Site Infections?

Infections occur when harmful microorganisms enter the surgical wound or deeper tissues. Common risk factors include:

  • Diabetes and poorly controlled blood glucose.

  • Smoking, obesity and poor nutritional status.

  • Existing infections or reduced immunity.

  • Inadequate infection prevention or delayed wound assessment.

Signs and Symptoms to Watch For

Recognising infection early can help prevent serious complications. Warning signs include:

  • Increasing redness, swelling or pain around the incision.

  • Pus, unusual discharge or unpleasant odour.

  • Fever, chills or feeling generally unwell.

  • Wound separation or new sternal instability.

Important: Suspected infection after cardiac surgery requires prompt clinical assessment. Severe breathlessness, confusion, collapse or rapidly worsening illness requires emergency medical attention.

Managing Cardiac Surgical Site Infections

Treatment depends on the severity and depth of infection and may include:

  1. Clinical assessment: Examine the wound and obtain appropriate microbiological samples.

  2. Antibiotic treatment: Use clinician-prescribed antibiotics guided by likely organisms, culture results and local protocols.

  3. Surgical intervention: Deep infections may require drainage, debridement and specialist surgical management.

  4. Advanced wound care: Appropriate dressings and, in selected cases, negative pressure wound therapy (NPWT) may support wound management.

Deep sternal infections require urgent specialist assessment. Dressings and advanced wound-care products must not replace appropriate infection treatment or surgical source control.

Precautions to Prevent Infection

Prevention should begin before surgery and continue throughout recovery.

  • Maintain strict hygiene: Follow hand hygiene, aseptic technique and appropriate dressing-change procedures.

  • Optimise patient health: Manage blood glucose, support adequate nutrition and encourage smoking cessation.

  • Follow surgical protocols: Use appropriate skin antisepsis and antimicrobial prophylaxis in accordance with clinical guidelines.

  • Monitor the wound: Check regularly for redness, discharge, increasing pain or delayed healing.

  • Educate patients: Provide clear wound-care instructions and explain when to seek medical advice.

The Role of Wound Care in Recovery

Effective wound management helps protect the incision, manage drainage and support healing. Dressing selection should reflect wound condition, exudate levels, surrounding skin and clinical requirements.

For complex or non-healing wounds, specialist tissue viability input may be appropriate. NPWT can be considered for selected wounds following clinical assessment.

Consistent monitoring, timely escalation and coordinated multidisciplinary care are key to achieving better outcomes.

The right post-op dressing at the right time reduces complications and plays an integral role in successful recovery.

Recommended dressings:
1. AQUACEL Ag+ Extra

Browse AQUACEL Ag+ Extra

2. Melgisorb Ag

Browse Melgisorb Ag Dressings

Conclusion

Cardiac surgical site infections can have serious consequences, but a structured approach to prevention, early recognition and appropriate management can help reduce their impact.

From preoperative risk assessment and surgical infection prevention to postoperative monitoring, specialist dressings and advanced wound-care technologies, every stage of the care pathway matters.

For healthcare professionals, consistent assessment, timely escalation and evidence-based wound management are essential. For patients, understanding the warning signs and knowing when to seek help can make a meaningful difference to recovery.

 

Clinical references

NICE: Surgical site infections — prevention and treatment (NG125)

Centers for Disease Control and Prevention (CDC). Surgical Site Infection Prevention Guideline.

 

Medical disclaimer: This article is for educational purposes only and does not replace professional medical advice. Suspected infection following cardiac surgery requires prompt assessment by a qualified healthcare professional.