Does locally administered gentamicin affect the incidence of sternal wound infections after coronary artery bypass graft surgery?
| Autor: | Zeki Kiliç, Ozan Onur Balkanay, Safa Gode, Gökhan Ipek, Suat Nail Ömeroğlu, Deniz Göksedef |
|---|---|
| Rok vydání: | 2015 |
| Předmět: |
Pulmonary and Respiratory Medicine
medicine.medical_specialty business.industry Incidence (epidemiology) Significant difference Placebo Wound infection Placebo group Surgery medicine.anatomical_structure Isotonic medicine Gentamicin Cardiology and Cardiovascular Medicine business medicine.drug Artery |
| Zdroj: | Turkish Journal of Thoracic and Cardiovascular Surgery. :32-38 |
| ISSN: | 1301-5680 |
| DOI: | 10.5606/tgkdc.dergisi.2015.10246 |
| Popis: | OZ Amac: Bu calismada koroner arter baypas greftleme (KABG) ameliyatinda gentamisin emdirilmis gaz kullaniminin sternal yara yeri enfeksiyonuna (SYYE) karsi koruyucu etkisi olup olmadigi arastirildi. Calisma plani: Cift-kor ve plasebo kontrollu calismaya 100 ardisik KABG hastasi dahil edildi. Hastalar gentamisin ve plasebo gruplari olmak uzere iki gruba ayrildi. Cerrahi sirasinda, gentamisin/izotonik solusyon emdirilmis gazlar sternum ekartorunun kenarlarinin altina yerlestirildi. Primer sonlanim noktalari SYYE gelisimi, yara revizyonu ve KABG sonrasi ilk 30 gun icinde mortalite idi. Iki grup istatistiksel olarak karsilastirildi. Bul gu lar: Alti hastada SYYE gelisti. Bu hastalarin ucunde etkilenme yuzeyeldi ve yara revizyonu gerekmedi. Diger uc hastada hem ciltte hem de ciltalti tabakalarda tutulum vardi ve bu hastalarin tumunde revizyon gerekti. Tum SYYE olgulari plasebo grubundaydi ve gruplar arasinda anlamli farklilik vardi (p=0.027). Hicbir hastada mortalite gozlenmedi. Sonuc:Gentamisin ve plasebo gruplari arasindaki istatistiksel karsilastirma anlamli bir farklilik gosterdi. Bu sonuc, lokal gentamisinli gaz kullaniminin en az gentamisin-kollajen implant kullanimi kadar etkili oldugunu ortaya koydu. Dolayisiyla, KABG sirasinda sternum ekartoru altina gentamisin emdirilmis gaz yerlestirilmesi SYYE oranlarinin azaltilmasinda faydali olabilir. Anahtarsozcukler: Antibiyotik profilaksisi; kardiyak cerrahi islemler; gentamisin; cerrahi yara enfeksiyonu. ABSTRACT Background:This study aims to investigate whether the use of gentamicin-soaked sponges during coronary artery bypass graft (CABG) surgery has a protective effect against sternal wound infection (SWI). Methods: We included 100 consecutive CABG patients in a double-blind and placebo controlled study. Patients were randomized into two groups as gentamicin and placebo groups. During surgery, gentamicin/isotonic solution absorbed sponges were placed beneath the edges of the sternum-retractor. Primary end points were the development of SWI, wound revision, and mortality within the first 30 days after CABG. Two groups were compared statistically. Results:Sternal wound infection developed in six patients. The impact in three patients was superficial, and no wound revision was required. In the other three patients, both cutaneous and subcutaneous layers of the skin were involved, and they all needed revision. All SWI cases were in the placebo group, and there was a significant difference between the groups (p=0.027). No mortality was observed in any patient. Conclusion: The statistical comparison between gentamicin and placebo groups showed a significant difference. This result revealed that local use of gentamicin-sponges can be at least as effective as the use of gentamicin-collagen implants. Therefore, placing gentamicin-soaked sponges beneath the sternum-retractor during CABG can be beneficial to decrease SWI rates. |
| Databáze: | OpenAIRE |
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