title: A retrospective non-randomized study on the impact of INTEGUSEAL, a preoperative microbial skin sealant, on the rate of surgical site infections after cardiac surgery.
abstract: OBJECTIVE
  Surgical site infection (SSI) remains a serious potential complication after cardiac surgery. This study evaluated the impact of a cyanoacrylate microbial skin sealant (INTEGUSEAL) on the rate of SSI in cardiac surgery patients.
  
  
  METHODS
  Between January 2006 and July 2008, 580 patients underwent cardiac surgery by a single surgeon (PMD). Standard preoperative skin preparation was performed in 280 patients (control group), and 300 patients (microbial skin sealant group) received microbial skin sealant in addition to standard preoperative preparation. Patient characteristics and preoperative and combined pre/intraoperative risk scores were evaluated. The primary study endpoint was freedom from SSI within 30 days.
  
  
  RESULTS
  Both groups were established in a 15-month period. Carotid artery disease, diabetes mellitus, congestive heart failure, previous cardiac surgery, and bilateral internal mammary artery use were significantly more common in the skin sealant group. Preoperative risk scores for the development of SSI in the two groups were similar. In the skin sealant group, the combined operative risk score for SSI was significantly higher (9.8±4.0 vs. 8.7±3.7; p<0.001) nevertheless the incidence of SSI was significantly lower (2.3% vs. 6.8%; p=0.011) than in the control group.
  
  
  CONCLUSIONS
  Changing a surgeon's standard preoperative practice by including a microbial skin sealant pretreatment significantly reduced the rate of SSI.
authors.affiliation: Department of Cardiovascular Surgery, Charité Hospital, Medical University Berlin, Chariteplatz 1, D-10117 Berlin, Germany. pascal.dohmen@yahoo.de
authors.forename: Pascal M
authors.initials: PM
authors.lastname: Dohmen
authors.forename: Davide
authors.initials: D
authors.lastname: Gabbieri
authors.forename: Alexander
authors.initials: A
authors.lastname: Weymann
authors.forename: Jörg
authors.initials: J
authors.lastname: Linneweber
authors.forename: Torsten
authors.initials: T
authors.lastname: Geyer
authors.forename: Wolfgang
authors.initials: W
authors.lastname: Konertz
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000891:Anti-Infective Agents, Local / Q000627:therapeutic use*; D006348:Cardiac Surgical Procedures / Q000009:adverse effects*; D003428:Cross Infection / Q000453:epidemiology / Q000382:microbiology / Q000517:prevention & control; D003487:Cyanoacrylates / Q000627:therapeutic use*; D005260:Female; D006090:Gram-Negative Bacteria / Q000187:drug effects / Q000302:isolation & purification; D016905:Gram-Negative Bacterial Infections / Q000453:epidemiology / Q000382:microbiology / Q000517:prevention & control; D016908:Gram-Positive Bacterial Infections / Q000453:epidemiology / Q000382:microbiology / Q000517:prevention & control; D006095:Gram-Positive Cocci / Q000187:drug effects / Q000302:isolation & purification; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000453:epidemiology / Q000382:microbiology / Q000517:prevention & control; D011300:Preoperative Care; D012189:Retrospective Studies; D012867:Skin / Q000382:microbiology*; D013530:Surgical Wound Infection / Q000453:epidemiology* / Q000382:microbiology / Q000517:prevention & control; D016896:Treatment Outcome
chemical_list: D000891:Anti-Infective Agents, Local; D003487:Cyanoacrylates