Mediastinitis

Mediastinitis is infection of the tissues in the mediastinum—the central chest compartment around the heart, great vessels, trachea, and oesophagus. After cardiac surgery, bacteria can move beyond the skin incision and sternum into this deep space. A draining incision with a new sternal click is therefore not a routine wound problem: the infection may have disrupted the sternum and can threaten cardiac function or progress to sepsis. The infection most often follows median sternotomy, although oesophageal perforation or instrumentation can also seed the mediastinum. The clinical model is deep infection leading to tissue destruction and sternal instability, followed by possible pericardial, vascular, or systemic complications. Nursing priorities run in parallel: identify the pattern, assess perfusion and respiratory status, protect the wound, obtain appropriate cultures without delaying urgent treatment, and escalate for surgical source control.