all authors declare that they have no conflicts of interest .   supporting grant provided by kci europe holding b.v .
 post - sternotomy mediastinitis is a serious complication after cardiothoracic surgery and contribute significantly to post - operative morbidity , mortality , and healthcare costs . 
 negative pressure wound therapy is today s golden standard for post - sternotomy mediastinitis treatment . 
 a systematic literature search was conducted at pubmed until october 2012 to analyse whether vacuum - assisted closure technique prevents mediastinitis after clean surgical incisions closure . today 
 s studies showed reduction of post - sternotomy mediastinitis including a beneficial socio - economic impact . 
 current studies , however included only high - risk patients , hence furthermore , larger randomised controlled trials are warranted to clarify the benefit for using surgical incision vacuum management systems in the general patient population undergoing sternotomy and clarify risk factor interaction . 