ISSN : 1301-5680
e-ISSN : 2149-8156
Turkish Journal of Thoracic and Cardiovascular Surgery     
Does locally administered gentamicin affect the incidence of sternal wound infections after coronary artery bypass graft surgery?
Ozan Onur Balkanay1, Deniz Göksedef2, Safa Göde3, Zeki Kılıç4, Suat Nail Ömeroğlu2, Gökhan İpek2
1Department of Cardiovascular Surgery, Manisa State Hospital, Manisa, Turkey
2Department of Cardiovascular Surgery, Cerrahpaşa Medical Faculty, İstanbul University, İstanbul, Turkey
3Department of Cardiovascular Surgery, İstanbul Mehmet Akif Ersoy Training and Research Hospital, İstanbul, Turkey
4Department of Cardiovascular Surgery, Şırnak State Hospital, Şırnak, Turkey
DOI : 10.5606/tgkdc.dergisi.2015.10246
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.

Keywords : Antibiotic prophylaxis; cardiac surgical procedures; gentamicin; surgical wound infection
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