Gentamicin-containing collagen implant reduces sternal wound complications after cardiac surgery: A retrospective analysis

Kępa, Krzysztof; Krzych, Łukasz J.; Krejca, Michał

doi:10.1016/j.ijsu.2014.11.040

Cited by 12 publications

(13 citation statements)

References 28 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Some studies have reported that an antibiotic-collagen sponge was effective for the prevention of DSWI. However, the results from different studies have been controversial (12,13,28,29). In this study, we showed that the group treated with intravenous antibiotic, sternal debridement and flap reconstruction had a better prognosis than the group treated with intravenous antibiotic and sternal debridement (30)(31)(32)(33).…”

Section: Discussionmentioning

confidence: 78%

“…However, the proportion of staphylococcus aureus varied from previous reports (2,8,21,24,25). Some studies have attempted to investigate the benefit of antibiotic prophylaxis and confirm that intervention strategies were efficient (12,13,22,26).…”

Section: Discussionmentioning

confidence: 97%

“…Improvements in aseptic technique and the prevention of antibiotic use may contribute to a reduction in the incidence of DSWI after cardiac surgery. Some studies have reported that antibiotic prophylaxis was beneficial for reducing the incidence of DSWI after the operation (12)(13)(14)(15).…”

Section: Discussionmentioning

confidence: 99%

See 2 more Smart Citations

Deep sternal wound infection after cardiac surgery in the Chinese population: a single-centre 15-year retrospective study

Pan¹,

Mo²,

Zhou³

et al. 2017

J. Thorac. Dis.

View full text Add to dashboard Cite

Background: Deep sternal wound infection (DSWI) is a severe complication following cardiac surgery. A retrospective study was implemented to determine the risks and clinical characteristics of DSWI after cardiac operation in the Chinese population.Methods: We analysed 7,944 consecutive patients who underwent cardiac surgery via median sternotomy from January 2002 to December 2016 at our institution. Multiple logistic regression analysis was used to identify risk factors for DSWI.Results: A total of 106 patients (1.33%) suffered from DSWI; significant risk factors included body mass index (BMI) (P=0.02; OR=1.08; 95% CI: 1.01-1.16) and reoperation (P<0.01; OR=5.93; 95% CI: 2.88-12.25).The most common bacterium involved in DSWI was staphylococcus aureus (23%). Among all DSWI patients, the overall survival rate of the group treated with flap reconstruction was significantly higher than that in the group treated with intravenous antibiotics and sternal debridement (87% vs. 59%, P=0.01).Conclusions: DSWI was associated with several risk factors. Effective intervention strategies could improve the outcome of patients undergoing cardiac surgery.

show abstract

Section: Discussionmentioning

confidence: 78%

Section: Discussionmentioning

confidence: 97%

See 1 more Smart Citation

Deep sternal wound infection after cardiac surgery in the Chinese population: a single-centre 15-year retrospective study

Pan¹,

Mo²,

Zhou³

et al. 2017

J. Thorac. Dis.

View full text Add to dashboard Cite

show abstract

“…This relationship was demonstrated by a clinical study of sternal wound infection, which reported that treatment of wound infection using a collagen implant impregnated with gentamicin was effective, even when antibiotic‐resistant S. epidermidis was present, presumably due to high local concentrations of gentamicin 36 . Indeed, the clinical efficacy of local delivery of gentamicin for prevention of surgical site infection has been demonstrated across multiple indications, including cardiac, orthopedic, and gastrointestinal procedures, without risk of systemic exposure 28,29,37–40 . The very high local gentamicin concentrations achieved in this study suggest that bacterial killing should occur rapidly for key bacterial species.…”

Section: Discussionmentioning

confidence: 62%

Preclinical evaluation of efficacy and pharmacokinetics of gentamicin containing extracellular‐matrix envelope

Sohail

Garrigos

Elayi

et al. 2020

Pacing Clinical Electrophis

View full text Add to dashboard Cite

Background Using synthetic antibiotic‐eluting envelope (ABE) is an effective intervention for prevention of cardiovascular implantable electronic device (CIED) infection. The biologic extracellular‐matrix envelope (ECME), may offer potential advantages over the synthetic ABE. To further minimize the risk of infection, the ECME can be hydrated in gentamicin prior to CIED implantation. We aimed to evaluate the efficacy and pharmacokinetics (PK) of gentamicin containing ECME in an animal model. Methods For all experiments, the ECME was hydrated in gentamicin (40 mg/Ml) (treatment) for 2 min. In vitro antimicrobial efficacy against six different bacterial species was assessed. In vivo experiments were conducted using a rabbit model of CIED pocket infection. Serum and ECM gentamicin concentrations were measured. Five different organisms were inoculated into the device pocket of control (ECME hydrated in 0.9% saline) and treatment groups. Macroscopic appearance and colony forming units from CIED, ECME, and tissue were determined. Results No bacteria were recovered from any culture after 12 h of exposure to the gentamicin containing ECME. Serum gentamicin levels dropped below the limit of quantification at 15 h after implant. Gentamicin concentration in the ECME remained relatively stable for up to 7 days. Signs of clinical infection were observed in the control but not in the treatment group. In the presence of gentamicin, statistically significant reduction was demonstrated across all tested bacterial species. Conclusions In this preclinical animal infection model, gentamicin containing ECME was highly effective in reducing bacterial burden in the implant pocket, while systemic exposure after implantation remained low.

show abstract

“…Moreover, the bacterial resistance of GS is lower than other aminoglycosides. Thus, GS has been widely used in the treatment of respiratory infections, suppurative peritonitis, biliary infection, intracranial infection, urinary tract infections and infected lacerations [25,26].…”

Section: Accepted Manuscriptmentioning

confidence: 99%

Porous magnesium loaded with gentamicin sulphate and in vitro release behavior

Jiang

Wang

et al. 2016

Materials Science and Engineering: C

View full text Add to dashboard Cite

Gentamicin-containing collagen implant reduces sternal wound complications after cardiac surgery: A retrospective analysis

Abstract: In routine clinical practice the addition of GCCI to standard infection prophylaxis reduces the risk of both SSWI and DSWI in high-risk patients undergoing cardiac surgery.

Cited by 12 publications

References 28 publications

Deep sternal wound infection after cardiac surgery in the Chinese population: a single-centre 15-year retrospective study

Deep sternal wound infection after cardiac surgery in the Chinese population: a single-centre 15-year retrospective study

Preclinical evaluation of efficacy and pharmacokinetics of gentamicin containing extracellular‐matrix envelope

Porous magnesium loaded with gentamicin sulphate and in vitro release behavior

Contact Info

Product

Resources

About