Gentamicin-Collagen Sponges for the Prevention of Surgical Site Infections: A Meta-Analysis of Randomized Controlled Trials

Konstantelias, Athanasios A.; Polyzos, Konstantinos A.; Falagas, Matthew E.

doi:10.1089/sur.2016.025

Cited by 9 publications

(3 citation statements)

References 28 publications

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“…In contrast to antibiotics applied as ointments, solutions, aerosols or gels, etc., the use of GICS in cardiac surgery patients appears to be more beneficial. Numerous studies indicate that GICSs significantly reduce the incidence of SSIs, both deep and superficial in cardiac surgery patients [ 23 , 129 , 130 , 131 , 132 , 133 , 134 , 135 ]. Due to the use of different protocols of managing cardiac surgery patients, the 2020 NICE recommendations allow practitioners to consider using gentamicin-collagen sponges in cardiac surgery, emphasising that the evidence for their effectiveness is limited [ 90 ].…”

Section: Ssi Preventionmentioning

confidence: 99%

Surgical Site Infection in Cardiac Surgery

Żukowska¹,

Żukowski

2022

JCM

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Surgical site infections (SSIs) are one of the most significant complications in surgical patients and are strongly associated with poorer prognosis. Due to their aggressive character, cardiac surgical procedures carry a particular high risk of postoperative infection, with infection incidence rates ranging from a reported 3.5% and 26.8% in cardiac surgery patients. Given the specific nature of cardiac surgical procedures, sternal wound and graft harvesting site infections are the most common SSIs. Undoubtedly, DSWIs, including mediastinitis, in cardiac surgery patients remain a significant clinical problem as they are associated with increased hospital stay, substantial medical costs and high mortality, ranging from 3% to 20%. In SSI prevention, it is important to implement procedures reducing preoperative risk factors, such as: obesity, hypoalbuminemia, abnormal glucose levels, smoking and S. aureus carriage. For decolonisation of S. aureus carriers prior to cardiac surgery, it is recommended to administer nasal mupirocin, together with baths using chlorhexidine-based agents. Perioperative management also involves antibiotic prophylaxis, surgical site preparation, topical antibiotic administration and the maintenance of normal glucose levels. SSI treatment involves surgical intervention, NPWT application and antibiotic therapy

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Section: Ssi Preventionmentioning

confidence: 99%

Surgical Site Infection in Cardiac Surgery

Żukowska¹,

Żukowski

2022

JCM

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“…Since 2000, many studies have been conducted on the development of new hemostatic and absorbent agents, and there is more and more evidence of their effectiveness in comparison with conventional gauze bandages (Konstantelias et al, 2016).…”

Section: Introductionmentioning

confidence: 99%

“…Therefore, the aim of this work was to develop and optimize the composition of a structured medical sponge based on a material of biological origin, namely, xenoderm, which is enriched with macro-and micronutrients, amino acids, and chlorhexidine digluconate (1%) as the active pharmaceutical ingredient (API), using QbD at each stage of technological formation (Leonard et al, 2016;Lytvynyuk et al, 2016;Pavliuk et al, 2020;Vons et al, 2018).…”

Section: Introductionmentioning

confidence: 99%

The development of biodegradable hemostatic and absorbable sponges containing chlorhexidine digluconate and their in vitro characterization—A QbD approach

Bohdana¹,

Mariana²,

Taras³

et al. 2022

J App Pharm Sci

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Medical sponges are one of the most common tools used in various fields of medicine and are used to close wound surfaces in burns and trophic ulcers, showing absorbent and antiseptic properties, and stimulate tissue regeneration. The aim of this study was to optimize the composition of medical sponges with chlorhexidine digluconate based on a material of natural origin -xenoderma. The central composite design was used to establish the relationship between independent variables such as quantities of medical gelatin, propyleneglycol, and formaldehyde and dependent variables such as pH, the percentage of water absorption, the degree of in vitro degradation, thickness, and the time of complete dissolution, in order to obtain the optimal formulation using Response Surface Methodology. Using the concept of Quality by Design, the desired quality target product profile, critical quality attributes, risk assessment by Failure Mode Effects Analysis was determined that the number of excipients affects the pharmaco-technological parameters. It was found that sponges that contain 2% medical gelatin, 1% propyleneglycol, and 0.75% formaldehyde, are the best in composition, in terms of pH, the percentage of water absorption, the degree of in vitro degradation, thickness, the time of complete dissolution, in comparison with all other compositions.

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Scientific Surgery

2017

British Journal of Surgery

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Gentamicin-Collagen Sponges for the Prevention of Surgical Site Infections: A Meta-Analysis of Randomized Controlled Trials

Abstract: When analyzing lower-quality studies or only clean procedures, GCS significantly reduced the risk of SSI. Further high-quality randomized studies are needed to confirm the benefit of GCS for lowering mortality rates.

Cited by 9 publications

References 28 publications

Surgical Site Infection in Cardiac Surgery

Surgical Site Infection in Cardiac Surgery

The development of biodegradable hemostatic and absorbable sponges containing chlorhexidine digluconate and their in vitro characterization—A QbD approach

Scientific Surgery

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