Open AccessIntraoperative local administration of antibiotics for prevention of sternal wound infection in cardiac surgery
Author(s) -
Н. Н. Шихвердиев,
Г. Г. Хубулава,
С. П. Марченко,
В. В. Суворов
Publication year - 2017
Publication title -
patologiâ krovoobraŝeniâ i kardiohirurgiâ/patologiâ krovoobrašeniâ i kardiohirurgiâ
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.136
H-Index - 3
eISSN - 2500-3119
pISSN - 1681-3472
DOI - 10.21688/1681-3472-2017-1-69-72
Subject(s) - medicine , cefazolin , antibiotics , vancomycin , gentamicin , anesthesia , incidence (geometry) , surgery , antibiotic prophylaxis , cardiac surgery , surgical wound , staphylococcus aureus , microbiology and biotechnology , genetics , physics , optics , bacteria , biology
Aim. The article compares the effects of local and systemic use of antibiotics on the incidence of sternal wound infection in patients undergoing cardiac surgery. Methods. 485 patients undergoing adult cardiac surgery for the incidence of sternal wound infection were retrospectively evaluated. The patients were divided into two groups who received systemic (cefazolin) and topical (vancomycin, gentamicin) administration of antibiotics for the prevention of sternal wound infection in the postoperative period. The incidence of sternal wound infection depending on the method of application of antibiotics was also assessed. Results. According to the results of the statistical analysis, intraoperative topical application of antibiotics (vancomycin and gentamicin) significantly reduced the cases of sternal wound infection from 7.9 to 0.45% (odds ratio of 1871.9; 95% confidence interval 1.67-2.1×106; p = 0.036). Thus, to improve the efficiency of impact on the pathogenic flora in the wound and to reduce the risk of sternal infection, topical application of antibacterial drugs: vancomycin for the cancellous bone of the sternum, gentamicin for irrigation of tissue during suturing the wound is one of the methods. Conclusion. As a result of the comparative analysis, prevention of sternal wound infection in cardiac patients with intraoperative topical antibiotics is more effective than systemic antibiotic prophylaxis. To reduce the risk of sternal wound infection, topical application of vancomycin as a putty for the cancellous bone of the sternum and gentamicin for irrigation of the soft tissue in the process of wound suturing is recommended. Received 16 August 2016. Accepted 22 November 2016. Conflict of interest: The authors declare no conflict of interest. Financing: The study had no sponsor’s support.