Role of hyperbaric oxygen therapy in the treatment of postoperative organ/space sternal surgical site infections.
BACKGROUND
A prospective trial was designed to evaluate the effect of hyperbaric oxygen (HBO) therapy on organ/space sternal surgical site infections (SSIs) following cardiac surgery that requires sternotomy.


METHODS
A total of 32 patients who developed postoperative organ/space sternal SSI were enrolled in this study from 1999 through 2005. All patients were offered HBO therapy. Group 1 included the patients who accepted and were able to undergo HBO therapy (n = 14); group 2 included patients who refused HBO therapy or had contraindications to it (n = 18).


RESULTS
The two groups were well matched at baseline with comparable preoperative clinical characteristics and operative factors. Staphylococcus was the most common pathogen for both groups. The duration of infection was similar in groups 1 and 2 (31.8 7.6 vs. 29.3 5.7 days, respectively, p = 0.357). The infection relapse rate was significantly lower in group 1 (0% vs. 33.3%, p = 0.024). Moreover, the duration of intravenous antibiotic use (47.8 +/- 7.4 vs. 67.6 +/- 25.1 days, p = 0.036) and total hospital stay (52.6 +/- 9.1 vs. 73.6 +/- 24.5 days, p = 0.026) were both significantly shorter in group 1.


CONCLUSIONS
Hyperbaric oxygen is a valuable addition to the armamentarium available to physicians for treating postoperative organ/space sternal SSI.
Barili
Fabio
F
Department of Cardiovascular Surgery, University of Milan, Centro Cardiologico Monzino IRCCS, Via Parea 4, 20138, Milan, Italy. fabarili@libero.it
Polvani
Gianluca
G
Topkara
Veli K
VK
Dainese
Luca
L
Cheema
Faisal H
FH
Roberto
Maurizio
M
Naliato
Moreno
M
Parolari
Alessandro
A
Alamanni
Francesco
F
Biglioli
Paolo
P
D000368:Aged; D016022:Case-Control Studies; D005260:Female; D006801:Humans; D006931:Hyperbaric Oxygenation; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D013249:Sternum / Q000601:surgery*; D013530:Surgical Wound Infection / Q000628:therapy*; D016896:Treatment Outcome