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Background: Deep sternal wound infection is a devastating, potentially life-threatening complication following cardiac surgery. It is associated with a significant increase in morbidity and mortality and also with a significant utilization of hospital resources. Aim: We sought to compare clinical outcomes, in-hospital mortality and 1-year survival of two different treatment modalities of deep sternal wound infection - topical negative pressure and conventional therapy. Methods: Prospective analysis of 62 consecutive patients treated for deep sternal infection at our institution. A total of 28 patients (February 2002 through October 2004) underwent conventional treatment and 34 patients (November 2004 through October 2007) underwent the application of topical negative pressure. Clinical and wound care outcomes of both treatment strategies DS focusing on therapeutic failure rate in-hospital and 1-year mortality DS were compared. Results: Topical negative pressure was associated with a significant lower failure rate of the primary therapy (p<0.05), a shortening of the intensive care unit stay (p<0.001), and, particularly, a decrease in the length of hospital stay (p<0.05) and the 1-year mortality (p<0.05). Comparable overall length of the therapy, in-hospital stay and the risk of wire-related fistulas after the chest reconstruction were found. Conclusion: Topical negative pressure is a superior method of treatment for deep sternal wound infection, based on lower therapeutic failure rate, significant decrease in hospital stay, and the decrease of 1-year mortality rate, compared with the conventional therapy methods. [ABSTRACT FROM AUTHOR] more...