Topical Vancomycin Reduces the Incidence of Deep Sternal Wound Complications After Sternotomy
| Autor: | Jürgen Leick, Alexandros Paraforos, Safwan Sino, Terrence John Donovan, Ivar Friedrich |
|---|---|
| Rok vydání: | 2022 |
| Předmět: |
Pulmonary and Respiratory Medicine
medicine.medical_specialty business.industry Incidence (epidemiology) medicine.medical_treatment medicine.disease_cause Interim analysis Methicillin-resistant Staphylococcus aureus Wound infection Surgery Median sternotomy medicine Vancomycin Cardiology and Cardiovascular Medicine business Adverse effect medicine.drug Surgical patients |
| Zdroj: | The Annals of Thoracic Surgery. 114:511-518 |
| ISSN: | 0003-4975 |
| Popis: | Background Deep sternal wound infection remains a significant hazard for cardiosurgical patients undergoing median sternotomy. Although the prophylactic use of topical vancomycin to reduce the incidence of deep sternal wound complications (DSWC) has been repeatedly examined, the method remains controversial. Methods We report here on a continuous experience which encompassed a total of 1251 cardiosurgical patients who underwent various procedures via median sternotomy. Beginning in October, 2015 and in response to a surge of DSWC (4.4%), 3 surgeons in our team began to apply 2.5 g of vancomycin paste to the sternal edges just prior to closure, while the remaining 2 surgeons did not. An interim analysis comparing the two groups suggested that vancomycin was indeed effective, and from February 2016 on, all surgeons adopted the routine use of vancomycin in all patients. Results Retrospective analysis of 496 surgical patients from January to September 2015 had revealed a baseline incidence of DSWC of 4.4%. In the divided-use period between October 2015 and February 2016, DSWC was seen in 8.6% (8/93) of the no-vancomycin group. In the vancomycin group, the incidence fell to 0.8% (1/129). In March 2016, all surgeons began using vancomycin and the overall rate of DSWC for all surgeons and all patients subsequently declined to 1.1%. No adverse effects were observed. Conclusions Topical vancomycin application is highly effective in the prevention of DSWC following median sternotomy. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|