Abstract

Delayed sternal wound infection is the most feared complication of a midline sternotomy. The incidence of sternal wound infection reported to be 1.5% and the longest delayed sternal wound infection was reported to be 417 days postoperatively [1,2]. This is a case of a patient with a comorbid of hypertension and chronic rheumatic heart disease, who presented with delayed sternal wound infection 5 years’ post midline sternotomy for aortic valve replacement. He is also a chain smoker, whom continued to smoke perioperatively till the current admission. There are many factors contributing to delayed sternal wound infection. However, in this patient there are few causes attributing to it such as smoking, Staphylococcus infection and biofilm. Although smoking and Staphylococcus infection has been extensively studied, the presence of biofilm as a cause for delayed sternal wound infection is still in progress.