Which condition significantly increases the risk of sternal wound infection after cardiac surgery?

The significant increase in the risk of sternal wound infection after cardiac surgery is notably linked to diabetes and obesity. Diabetes impairs wound healing due to factors such as vascular insufficiency and an altered immune response, which can lead to a higher likelihood of infection. In patients with diabetes, elevated blood glucose levels can inhibit the function of neutrophils and other immune cells, making the body less capable of combating infections that may arise post-surgery.

Obesity is also a critical factor, as it is associated with increased tissue hypoxia, poor perfusion, and mechanical stress on the surgical site, which can further compromise healing. In addition, in obese patients, the presence of excess adipose tissue can increase the difficulty of achieving proper wound closure and may accumulate fluid, leading to seromas that raise the risk of infection.

While hypertension, hyperlipidemia, smoking, alcohol use, pneumonia, and renal dysfunction can contribute to overall patient risk and complicate recovery, their direct association with sternal wound infection is not as strong as that of diabetes and obesity. Thus, understanding the interplay between these specific conditions and their impact on surgical outcomes is crucial for optimizing patient care and promoting better recovery following cardiac procedures.