Sternal wound infection post cardiac surgery is a preventable complication

Dear Editor,

We read with great interest the article (The Early Diagnostic Value of C-reactive Protein (CRP) in Deep Sternal Wound Infection After Cardiac Surgery) by Shanshan Jia and colleagues, ¹ which highlights the diagnostic utility of C-reactive protein (CRP) levels on postoperative days 10 and 14 for early detection of deep sternal wound infection (DSWI) following cardiac surgery. The authors are to be commended for their contribution to improving awareness and surveillance of this potentially devastating and preventable complication.^2,3

While we agree that biochemical markers like CRP may assist in identifying DSWI, we believe this approach must be firmly rooted in clinical context. Early recognition of DSWI is most effectively guided by clinical judgment, including patient-specific risk factors (e.g. obesity, diabetes, and reoperation), surgical technique, and early physical signs such as sternal instability or localized drainage.^4,5

In practice, elevated CRP levels often reflect a wide range of postoperative inflammatory responses, and their specificity is limited without a corresponding clinical suspicion. Over reliance on CRP trends may delay necessary interventions, whereas a vigilant bedside assessment remains irreplaceable in timely management. A combined approach, anchored in clinical sense and supported by laboratory data, is the most prudent strategy. We appreciate the authors’ efforts and hope future studies will continue integrating laboratory and bedside insights to optimize early DSWI diagnosis and outcomes.