Effectiveness of collagen-gentamicin implant for treatment of "dirty" abdominal wounds.
The purpose of this work was to compare the efficacy and safety of the collagen-gentamicin sponge with conventional treatment (wound open, maintaining a close observation, and cleaning it daily with antiseptics) for the prophylaxis of infection in "dirty" abdominal wounds. Seventy-three patients with dirty abdominal wounds caused by gastrointestinal tract surgery were studied. The patients were randomized in two groups: group A, open wounds, treated with local cleansing, metronidazole 20 to 40 mg/kg/day IV and gentamicin 5 mg/kg/day IV for 7 days. Group B, primary closure with collagen-gentamicin implant plus metronidazole 20 to 40 mg/kg/day IV for 7 days. Surgical wound infections were significantly reduced by the collagen-gentamicin implant. Polymicrobial infections were observed in group A, whereas the infections were caused only by a single organism in group B. In conclusion, the collagen-gentamicin implant is effective and well tolerated in the treatment of "dirty" surgical abdominal wounds because it significantly reduces the wound infection rate (p < 0.01) and shortens healing time (p < 0.001) and the period of disability.
Guzmán Valdivia Gomez
G
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Department of General Surgery, Regional General Hospital No. 1 "Gabriel Mancera", Mexican Institute of Social Security (IMSS), Gabriel Mancera 222, Colonia del Valle, C.P. 03100, Mexico City, Mexico.
Guerrero
T S
TS
Lluck
M C
MC
Delgado
F J
FJ
D000293:Adolescent; D000328:Adult; D000368:Aged; D000900:Anti-Bacterial Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D000890:Anti-Infective Agents / Q000627:therapeutic use; D000891:Anti-Infective Agents, Local / Q000008:administration & dosage / Q000627:therapeutic use; D001064:Appendicitis / Q000601:surgery; D001424:Bacterial Infections / Q000175:diagnosis; D003094:Collagen / Q000008:administration & dosage / Q000627:therapeutic use*; D003108:Colonic Diseases / Q000601:surgery; D004343:Drug Implants; D005260:Female; D005705:Gallbladder Diseases / Q000601:surgery; D005781:Gelatin Sponge, Absorbable; D005839:Gentamicins / Q000008:administration & dosage / Q000627:therapeutic use*; D006801:Humans; D007416:Intestinal Perforation / Q000601:surgery; D008297:Male; D008795:Metronidazole / Q000627:therapeutic use; D008875:Middle Aged; D011206:Povidone-Iodine / Q000008:administration & dosage / Q000627:therapeutic use; D012422:Rupture, Spontaneous / Q000601:surgery; D013530:Surgical Wound Infection / Q000188:drug therapy* / Q000382:microbiology; D014945:Wound Healing
D000900:Anti-Bacterial Agents; D000890:Anti-Infective Agents; D000891:Anti-Infective Agents, Local; D004343:Drug Implants; D005839:Gentamicins; D008795:Metronidazole; D011206:Povidone-Iodine; D003094:Collagen