Letters Section Editor: Robert M. Golub, MD, Senior Editor.
In Reply: Dr Scheckler described the rate of deep surgical site infection (SSI) in our study as high, comparing it with an incidence of poststernotomy mediastinitis in the United States of less than 1%. However, we reported the incidence of deep SSIs, comprising a group of SSIs greater than poststernotomy mediastinitis alone. In the United States, the comparable incidence is likely to be higher as well. An incidence of 0.4% to 5.0% for poststernotomy mediastinitis has been reported in other studies.1,2 In our study, the overall incidence of poststernotomy mediastinitis was 1.6% (0.8% in the chlorhexidine group and 2.3% in the placebo group). Therefore, we believe that our preventive strategy can also improve the outcomes in the United States.
Segers P, Speekenbrink RGH, Ubbink DT, van Ogtrop ML, de Mol BA. Chlorhexidine Gluconate for Prevention of Nosocomial Infection in Cardiac Surgery—Reply. JAMA. 2007;297(10):1059-1060. doi:10.1001/jama.297.10.1060