Prevention of surgical site infection by antibiotic spraying in the operative field during cardiac surgery.
OBJECTIVE
Despite the many procedures introduced to prevent surgical site infection during cardiothoracic surgery, serious infections still occur. We attempted to reduce surgical site infection by spraying antibiotic solution in the operative field--a procedure since introduced at 4 other Japanese institutions.


METHODS
In the latter half of 1990, we began spraying an antibiotic solution of cefazolin (1g) and gentamicin (40 mg)/40 ml of saline placed in a 50 ml syringe and dispensed through an 18 G needle bent at 60 to 80 degrees to clean the wound during surgery.


RESULTS
No deep surgical site infections or deaths due to infection have occurred among the 502 patients undergoing cardiothoracic surgery under cardiopulmonary bypass at our hospital. This method was used in over 2,100 cases of similar procedures at 4 other institutions. There were 3 deaths due to severe surgical site infection (0.11%). At one institution treating over 1,000 cases a year, the incidence of death due to surgical site infection decreased significantly after this method was introduced.


CONCLUSIONS
These preliminary experiences show that spraying antibiotic solution in the operative field reduces the risk of surgical site infection in cardiothoracic surgery.
Yoshii
S
S
Department of Surgery, Yamanashi Medical University, 1110 Tamaho-cho, Nakakoma-gun, Yamanashi 409-3898, Japan.
Hosaka
S
S
Suzuki
S
S
Takahashi
W
W
Okuwaki
H
H
Osawa
H
H
Abraham
S J
SJ
Tada
Y
Y
D000336:Aerosols; D000900:Anti-Bacterial Agents / Q000008:administration & dosage*; D006348:Cardiac Surgical Procedures / Q000379:methods*; D006801:Humans; D009873:Operating Rooms; D013530:Surgical Wound Infection / Q000517:prevention & control*
D000336:Aerosols; D000900:Anti-Bacterial Agents