ReviewMediastinum (Hong Kong, China)2026
Mediastinitis after cardiac surgery, from microbes to management: a systematic review.
Review in Mediastinum (Hong Kong, China), 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
0 citing papers in PubMed.
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Corrections and comments
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Authors and funding
5 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Background: Post-sternotomy mediastinitis is a complication of cardiac surgery associated with substantial morbidity, mortality, and healthcare burden. Despite advances in surgical technique, perioperative care, and infection control, patient risk profiles and surveillance methodologies continue to drive variation in reported incidence rates. The objective of this systematic review is to review the evidence on incidence, microbiology, risk factors, prevention, and management of mediastinitis after cardiac surgery. Methods: A systematic search of Ovid MEDLINE and EMBASE was performed from inception to October 2025 following PRISMA 2020 guidelines (registration CRD420251177438). Eligible studies included adult patients undergoing cardiac surgery with reported outcomes on mediastinitis incidence, mortality, microbiology, prevention, or management. Case reports, conference abstracts, and narrative reviews were excluded. Data were extracted on study design, population characteristics, pathogen distribution, preventive strategies, and management approaches. Due to heterogeneity in study designs and outcome definitions, a meta-analysis was not performed. Results: 60 studies met inclusion criteria. Across over 400,000 patients, the reported incidence of mediastinitis ranged from 0.2% to 11.0%, with contemporary series typically reporting 0.5-3%. Mortality ranged from 1.5% in contemporary early-treated cohorts to 40-60% in delayed, recurrent, or fungal mediastinitis complicated by sepsis. Conclusions: Post-sternotomy mediastinitis remains a preventable systemic complication. Bundled perioperative strategies, meticulous sternal technique, optimized perfusion and metabolic control, and coordinated multidisciplinary management offer the greatest potential to reduce incidence and improve outcomes. Future research should standardize definitions, refine prophylaxis bundles, optimize antimicrobial duration, and integrate advanced diagnostics for early detection of biofilm-mediated infection.
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