Local application of gentamicin-containing collagen implant in the prophylaxis and treatment of surgical site infection following vascular surgery.
BACKGROUND
The development of surgical site infection (SSI) following vascular surgery is an important issue for healthcare providers as it has serious implications for both patient morbidity and mortality.


METHODS
Five publications were identified using the PubMed online database and search terms 'gentamicin-containing collagen implant' plus 'surgical site infection', 'wound infection' and 'vascular surgery'.


RESULTS
The reviewed publications demonstrated that prophylactic use of GCCI in conjunction with standard treatment reduces the SSI rate in patients operated on for femeropopliteal bypass grafting. The prophylactic use of GCCI may also have a role to play in patients at high-risk of infection (e.g. in those with co-morbidities such as obesity) and in high-risk procedures (e.g. surgical revision to correct anastomotic aneurysm or dehiscence). GCCI in conjunction with systemic antibiotics may also be effective in the treatment of wound infections of the groin following vascular reconstruction.


CONCLUSIONS
This review demonstrates that GCCI have a role to play in preventing and treating SSI following vascular reconstruction when used in conjunction with standard treatment approaches. Additional randomised, controlled studies are required to further establish the efficacy and cost-effectiveness of GCCI in vascular surgery.
Department of Vascular Surgery, Northwick Park University Hospital, Watford Road, Harrow HA1 3UJ, London, United Kingdom. tahirhussain@nhs.net
Syed Tahir
ST
Hussain
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000900:Anti-Bacterial Agents / Q000008:administration & dosage / Q000494:pharmacology / Q000627:therapeutic use*; D019072:Antibiotic Prophylaxis / Q000379:methods; D001419:Bacteria / Q000187:drug effects; D015331:Cohort Studies; D024042:Collagen Type I / Q000008:administration & dosage / Q000627:therapeutic use*; D004343:Drug Implants / Q000008:administration & dosage / Q000494:pharmacology / Q000627:therapeutic use*; D005260:Female; D005839:Gentamicins / Q000008:administration & dosage / Q000494:pharmacology / Q000627:therapeutic use*; D006801:Humans; D008297:Male; D008826:Microbial Sensitivity Tests; D008875:Middle Aged; D013530:Surgical Wound Infection / Q000188:drug therapy / Q000517:prevention & control / Q000628:therapy*; D058017:Vascular Grafting / Q000379:methods*
D000900:Anti-Bacterial Agents; D024042:Collagen Type I; D004343:Drug Implants; D005839:Gentamicins