{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T04:34:21Z","timestamp":1791261261948,"version":"4.1.0"},"reference-count":25,"publisher":"SAGE Publications","issue":"7","license":[{"start":{"date-parts":[[2026,3,4]],"date-time":"2026-03-04T00:00:00Z","timestamp":1772582400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2026,3,4]],"date-time":"2026-03-04T00:00:00Z","timestamp":1772582400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Surgical Infections"],"published-print":{"date-parts":[[2026,9,1]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Post-sternotomy mediastinitis (PSM) is a rare but life-threatening complication of cardiac surgical procedures. This study evaluated the impact of a structured multi-disciplinary post-discharge care bundle on PSM incidence.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>A single-center, retrospective cohort study compared the incidence of PSM two years before and after implementation of a care bundle led by a multi-disciplinary team. The intervention included telephonic monitoring, a specialized wound-care clinic, and a standardized two-phase wound management protocol incorporating single-use negative pressure wound therapy. Outcomes were assessed using chi-square tests and logistic regression adjusted with propensity scores and inverse probability weighting. To rule out a temporal trend in newly identified wound infections, we performed a linear regression using bimonthly incident counts as the outcome.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>A total of 1,197 patients underwent median sternotomy between May 1, 2018, and April 30, 2022. The crude incidence of PSM was 3.32% in the pre-implementation group and 1.56% in the post-implementation group (p = 0.058). After adjustment with inverse probability of treatment weighting, the care bundle was associated with a significant reduction in PSM rate (absolute risk difference 1.96%, 95% confidence interval [CI]: 0.54\u20133.87; p = 0.044; relative reduction 59%, 95% CI: 16.3%\u2013116%), despite a higher baseline surgical risk in the post-implementation cohort (higher EuroSCORE II, more urgent procedures, greater need for vasoactive support). The rate of newly identified wound infections did not exhibit a significant time trend (\u03b2 = \u20130.43; p = 0.299).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>Implementation of a multi-disciplinary care bundle is significantly associated with a reduction in PSM incidence in cardiac sternotomy patients, underscoring the importance of structured outpatient wound surveillance.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/10962964261428654","type":"journal-article","created":{"date-parts":[[2026,3,11]],"date-time":"2026-03-11T15:29:00Z","timestamp":1773242940000},"page":"510-516","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":1,"title":["Multi-Disciplinary and Protocol-Driven Post-Operative Care Reduces Incidence of Post-Sternotomy Mediastinitis"],"prefix":"10.1177","volume":"27","author":[{"given":"David","family":"Fern\u00e1ndez-de-Velasco","sequence":"first","affiliation":[{"name":"Department of Internal Medicine, Hospital Universitario Alcorcon, Madrid, Spain."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Manuel","family":"Carnero-Alc\u00e1zar","sequence":"additional","affiliation":[{"name":"Department of Cardiac Surgery, Hospital Cl\u00ednico Universitario San Carlos, Madrid, Spain."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fernando-Jose","family":"Reguillo-Lacruz","sequence":"additional","affiliation":[{"name":"Department of Cardiac Surgery, Hospital Cl\u00ednico Universitario San Carlos, Madrid, Spain."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Juan-Miguel Miranda","family":"Torr\u00f3n","sequence":"additional","affiliation":[{"name":"Department of Cardiac Surgery, Hospital Cl\u00ednico Universitario San Carlos, Madrid, Spain."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cristina","family":"Villamor-Jim\u00e9nez","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Hospital Universitario Alcorcon, Madrid, Spain."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jorge","family":"Calleja-Sanz","sequence":"additional","affiliation":[{"name":"Department of Medicine, Division of Hospital Medicine, Hospital Universitario Cl\u00ednico San Carlos, Universidad Complutense deMadrid, Madrid, Spain."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pilar","family":"Ruiz-\u00c1lvarez","sequence":"additional","affiliation":[{"name":"Department of Cardiac Surgery, Hospital Cl\u00ednico Universitario San Carlos, Madrid, Spain."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luis","family":"Maroto-Castellanos","sequence":"additional","affiliation":[{"name":"Department of Cardiac Surgery, Hospital Cl\u00ednico Universitario San Carlos, Madrid, Spain."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0006-2469-4619","authenticated-orcid":false,"given":"Sally","family":"Moores","sequence":"additional","affiliation":[{"name":"Global Clinical Strategy, Smith and Nephew, Hull, UK."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria Arantzazu","family":"\u00c1lvarez-de-Arcaya","sequence":"additional","affiliation":[{"name":"Department of Medicine, Division of Hospital Medicine, Hospital Universitario Cl\u00ednico San Carlos, Universidad Complutense deMadrid, Madrid, Spain."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,3,4]]},"reference":[{"key":"e_1_3_5_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejcts.2006.09.020"},{"key":"e_1_3_5_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cmi.2019.07.005"},{"key":"e_1_3_5_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.hrtlng.2022.04.013"},{"key":"e_1_3_5_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajic.2008.03.002"},{"key":"e_1_3_5_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0003-4975(97)01003-5"},{"key":"e_1_3_5_7_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13019-014-0179-4"},{"key":"e_1_3_5_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0003-4975(00)01814-2"},{"key":"e_1_3_5_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.athoracsur.2006.05.097"},{"key":"e_1_3_5_10_1","doi-asserted-by":"publisher","DOI":"10.1111\/jocs.13189"},{"key":"e_1_3_5_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejcts.2009.10.005"},{"key":"e_1_3_5_12_1","doi-asserted-by":"publisher","DOI":"10.1089\/sur.2022.176"},{"issue":"4","key":"e_1_3_5_13_1","first-page":"375","article-title":"Is post-sternotomy mediastinitis still devastating after the advent of negative-pressure wound therapy","volume":"38","author":"De Feo M","year":"2011","unstructured":"12.De Feo M, , Della Corte A, , Vicchio M, et al. Is post-sternotomy mediastinitis still devastating after the advent of negative-pressure wound therapy? Tex Heart Inst J 2011;38(4):375\u2013380.","journal-title":"Tex Heart Inst J"},{"key":"e_1_3_5_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejcts.2010.01.028"},{"key":"e_1_3_5_15_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.athoracsur.2020.03.087"},{"key":"e_1_3_5_16_1","doi-asserted-by":"publisher","DOI":"10.1111\/iwj.14599"},{"key":"e_1_3_5_17_1","doi-asserted-by":"publisher","DOI":"10.1093\/bjsopen\/zraa003"},{"key":"e_1_3_5_18_1","doi-asserted-by":"publisher","DOI":"10.2478\/pjs-2014-0082"},{"key":"e_1_3_5_19_1","unstructured":"18.US CFDCC. Surgical Site Infection Event (SSI). NHSN; 2025. Available from: https:\/\/www.cdc.gov\/nhsn\/pdfs\/pscmanual\/9pscssicurrent.pdf"},{"key":"e_1_3_5_20_1","doi-asserted-by":"publisher","DOI":"10.3390\/jcm10235566"},{"issue":"12","key":"e_1_3_5_21_1","first-page":"Cd013332","article-title":"Interventions to prevent surgical site infection in adults undergoing cardiac surgery","volume":"2024","author":"Rogers LJ","year":"2024","unstructured":"20.Rogers LJ, , Vaja R, , Bleetman D, , Cochrane Central Editorial Service et al.;. Interventions to prevent surgical site infection in adults undergoing cardiac surgery. Cochrane Database Syst Rev 2024;2024(12):Cd013332.","journal-title":"Cochrane Database Syst Rev"},{"key":"e_1_3_5_22_1","doi-asserted-by":"publisher","DOI":"10.1086\/646718"},{"key":"e_1_3_5_23_1","doi-asserted-by":"publisher","DOI":"10.1002\/dmrr.3266"},{"key":"e_1_3_5_24_1","doi-asserted-by":"publisher","DOI":"10.1017\/ice.2023.67"},{"key":"e_1_3_5_25_1","doi-asserted-by":"publisher","DOI":"10.1111\/wrr.12966"},{"issue":"3","key":"e_1_3_5_26_1","article-title":"Demonstrating negative pressure wound therapy in the management of non-healing surgical wounds: A case series","volume":"25","author":"Doreen H","year":"2024","unstructured":"25.Doreen H, , Rainer S, , Joanne H, et al. Demonstrating negative pressure wound therapy in the management of non-healing surgical wounds: A case series. 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