**5. Incidence**

Despite advancements in most aspects of perioperative care, rates of sternal wound complications, including mediastinitis, following adult cardiac surgery have varied little over the past 30 years [2-6], although incremental reduction in single center rates of DSWI have been noted and attributed to adjunctive measures such as strict perioperative glucose control [40]. As noted previously, rates of DSWI vary with regard to the specific definition used to describe the pathology encountered and the patient population studied. In general, reported rates of DSWI are relatively low, ranging from 0.25% to 3.6 % [2-9, 38, 39, 41, 42]. However, the incidence of superficial sternal infection excedes that of deep sternal infection by as many as three times [10, 41, 43], and Francel has stated that as many as 70% of patients with poststernotomy infection will have superficial tissue involvement [44].
