Skin sealant InteguSeal® has no impact on prevention of postoperative mediastinitis after cardiac surgery.
BACKGROUND
Surgical site infections (SSIs) after median sternotomy represent a serious complication and a high potential risk for adverse clinical outcome after cardiac surgery. The antimicrobial skin sealant InteguSeal® was introduced as a novel tool in preventing development of SSI.


OBJECTIVE
This single-centre investigation used two prospective registries to evaluate the prophylactic effect of a cyanoacrylate-based antimicrobial skin sealant (InteguSeal®) on the incidence of postoperative mediastinitis or any other form of chest skin incision SSI after elective cardiac surgery.


METHODS
Between October 2010 and April 2011 a total of 998 patients underwent elective cardiac surgical procedures with median sternotomy in our centre. In 496 patients InteguSeal® was included in standard preoperative preparation procedures before chest skin incision (group 1). In 502 patients standard preoperative skin preparation procedures were used without InteguSeal® (group 2). Freedom from mediastinitis and from any other form of SSI within 30 postoperative days were the primary and secondary endpoints, respectively.


RESULTS
A total of 983 patients were eligible for inclusion in per-protocol analysis (488 vs 495 patients). The incidence of postoperative mediastinitis was 2.3% in group 1 vs 3.2% in group 2 (not significant). The incidence of any form of SSI was 10.9% in group 1 vs 11.5% in group 2 (not significant). Perioperative patient characteristics, complexity of surgical procedures performed and length of hospitalization were similar in both groups.


CONCLUSIONS
The use of InteguSeal® has no influence on the incidence of postoperative SSI and mediastinitis after cardiac surgery with median sternotomy.
Dresden Heart Center, Department of Cardiac Surgery, Fetscherstrasse 76, Dresden, Germany. Thomas.Waldow@mailbox.tu-dresden.de
T
T
Waldow
M
M
Szlapka
J
J
Hensel
K
K
Plötze
K
K
Matschke
L
L
Jatzwauk
D000368:Aged; D000891:Anti-Infective Agents, Local / Q000627:therapeutic use*; D003487:Cyanoacrylates / Q000627:therapeutic use; D006801:Humans; D015994:Incidence; D008297:Male; D008480:Mediastinitis / Q000453:epidemiology* / Q000517:prevention & control*; D008875:Middle Aged; D012867:Skin; D013530:Surgical Wound Infection / Q000453:epidemiology* / Q000517:prevention & control*; D013903:Thoracic Surgery; D014014:Tissue Adhesives / Q000627:therapeutic use*; D016896:Treatment Outcome
D000891:Anti-Infective Agents, Local; D003487:Cyanoacrylates; D014014:Tissue Adhesives