Adjuvant treatment of deep sternal wound infection with collagenous gentamycin.
BACKGROUND
The treatment of deep sternal wound infections remains controversial. Currently advocated procedures carry the risk of reinfections. The significance of local antibiotic-releasing systems as an adjuvant therapy to avoid reinfections is the subject of the presented study.


METHODS
Forty-two patients with deep sternal wound complication were treated with radical wound debridement, sternal refixation, retrosternal suction drainage, bilateral pectoralis major muscle flaps, and placement of collagenous drug carrier loaded with gentamycin (Sulmycin Implant) underneath, above, and between the sternal edges.


RESULTS
No treatment failure and death were observed in our patients. Side effects after adjuvant treatment with collagenous gentamycin were not detected.


CONCLUSIONS
The preliminary results of adjuvant therapy with collagenous gentamycin in combination with surgical debridement leads to excellent results in the treatment of early deep sternal wound infections with no death and no primary treatment failures. This technique is easy to perform, reliable, and safe. For final judgment controlled randomized trials are mandatory.
Leyh
R G
RG
Department of Cardiac Surgery, University of Lübeck, Germany.
Bartels
C
C
Sievers
H H
HH
D000368:Aged; D003094:Collagen; D003131:Combined Modality Therapy; D003646:Debridement; D004337:Drug Carriers; D004343:Drug Implants; D005260:Female; D005839:Gentamicins / Q000008:administration & dosage*; D006801:Humans; D008297:Male; D008875:Middle Aged; D012086:Reoperation; D013249:Sternum / Q000601:surgery*; D013530:Surgical Wound Infection / Q000601:surgery*; D016896:Treatment Outcome
D004337:Drug Carriers; D004343:Drug Implants; D005839:Gentamicins; D003094:Collagen