Dermacyn irrigation in reducing infection of a median sternotomy wound.
BACKGROUND
Sternal wound infection is an infrequent yet potentially devastating complication following sternotomy. Among the standard practices used as preventive measures are the use of prophylactic antibiotics and povidone-iodine as an irrigation agent. A new antiseptic agent, Dermacyn super-oxidized water (Oculus Innovative Sciences), has recently been used as a wound-irrigation agent before the closure of sternotomy wounds.


METHODS
This prospective, randomized clinical trial was conducted to compare the effectiveness of Dermacyn and povidone-iodine in reducing sternotomy wound infection in patients undergoing coronary artery bypass graft surgery. Upon chest closure and after insertion of sternal wires, wounds were soaked for 15 minutes with either Dermacyn or povidone-iodine. Subcutaneous tissue and skin were then closed routinely. Patients were followed up, and any wound infection was analyzed.


RESULTS
Of the 178 patients, 88 patients were in the Dermacyn group, and 90 were in the povidone-iodine group. The mean (+/-SD) age of the patients was 61.1 +/- 7.6 years. The incidence of sternotomy wound infection was 19 cases (10.7%). Five (5.7%) of these cases were from the Dermacyn group, and 14 (15.6%) were from the povidone-iodine group (P = .033). No Dermacyn-related complication was identified.


CONCLUSIONS
We found Dermacyn to be safe and more effective as a wound-irrigation agent than povidone-iodine for preventing sternotomy wound infection.
Mohd
Abdul Ramzisham Rahman
AR
Heart and Lung Centre, Universiti Kebangsaan Malaysia Medical Centre, Kuala Lumpur, Malaysia. ramzisham@hotmail.com
Ghani
Mohd Khairulasri
MK
Awang
Raflis Ruzairee
RR
Su Min
Joanna Ooi
JO
Dimon
Mohd Zamrin
MZ
D000368:Aged; D000891:Anti-Infective Agents, Local / Q000627:therapeutic use*; D001424:Bacterial Infections / Q000453:epidemiology / Q000209:etiology; D015897:Comorbidity; D001026:Coronary Artery Bypass / Q000379:methods; D003324:Coronary Artery Disease / Q000453:epidemiology / Q000601:surgery; D004338:Drug Combinations; D005260:Female; D006801:Humans; D006997:Hypochlorous Acid / Q000627:therapeutic use*; D015994:Incidence; D007362:Intensive Care Units; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D011206:Povidone-Iodine / Q000627:therapeutic use*; D012121:Respiration, Artificial / Q000009:adverse effects; D012907:Smoking / Q000009:adverse effects; D012973:Sodium Hypochlorite / Q000627:therapeutic use*; D056346:Sternotomy / Q000009:adverse effects*; D013249:Sternum / Q000601:surgery*; D013530:Surgical Wound Infection / Q000453:epidemiology / Q000209:etiology / Q000382:microbiology / Q000517:prevention & control*; D007507:Therapeutic Irrigation; D013997:Time Factors; D016896:Treatment Outcome
D000891:Anti-Infective Agents, Local; D004338:Drug Combinations; C554598:dermacyn; D006997:Hypochlorous Acid; D011206:Povidone-Iodine; D012973:Sodium Hypochlorite