Letter to the Editor

We reviewed with concern the article by Apelt et al. [1]. They report their root cause analysis of increased surgical site infections after their pectus repairs. From a scientific standpoint, reporting a root cause analysis as a “study” severely jeopardizes equipoise as an increased rate of complication is known a priori. In 21 cases, they experienced 6 (29%) infections. This would be the single highest infectious complication rate reported in the pectus literature, and inconsistent with prior publications.