title: The protective effect of topical rifamycin treatment against sternal wound infection in diabetic patients undergoing on-pump coronary artery bypass graft surgery.
abstract: OBJECTIVE
  The aim of this study was to investigate the protective effect of topical rifamycin SV treatment against sternal wound infection (SWI) in diabetic patients undergoing on-pump coronary artery bypass graft (CABG) surgery.
  
  
  METHODS
  One hundred and fifty-nine diabetic patients who were scheduled to undergo isolated on-pump CABG surgery were included. Eight were excluded for various reasons. Of the 151 patients, 51 were on insulin therapy and 100 were on oral anti-diabetics. The risk of mediastinitis was assessed using the American College of Cardiology/American Heart Association 2004 guideline update for CABG surgery. According to the risk scores, patients were divided into two comparable groups: the rifamycin group (n = 78) received topical rifamycin treatment after on-pump CABG surgery, and the control group (n = 73) received no topical treatment.
  
  
  RESULTS
  Deep sternal wound infection (mediastinitis) was not observed in either group (0/78 vs 0/73, p = 1.0). No superficial sternal wound infection was observed in the rifamycin group, however, it did occur in one patient in the control group (0/78 vs 1/73, p = 0.303). Wound culture was performed and coagulase-negative staphylococci were observed. The infection regressed on initiation of antibiotic therapy against isolated bacteria and the patient was discharged after a full recovery.
  
  
  CONCLUSIONS
  Although the difference in rate of superficial sternal wound infection (SSWI) in the rifamycin and control groups was not statistically significant, locally applied rifamycin SV during closure of the sternum in the CABG operation may have had a protective affect against SWI.
authors.affiliation: Department of Cardiovascular Surgery, School of Medicine, Mevlana University, Konya, Turkey.
authors.forename: Fatih
authors.initials: F
authors.lastname: Aygün
authors.affiliation: Department of Cardiovascular Surgery, School of Medicine, Mevlana University, Konya, Turkey.
authors.forename: Ahmet
authors.initials: A
authors.lastname: Kuzgun
authors.affiliation: Department of Cardiology, School of Medicine, Mevlana University, Konya, Turkey.
authors.forename: Seref
authors.initials: S
authors.lastname: Ulucan
authors.affiliation: Department of Cardiology, School of Medicine, Mevlana University, Konya, Turkey.
authors.forename: Ahmet
authors.initials: A
authors.lastname: Keser
authors.affiliation: Department of Cardiology, School of Medicine, Erciyes University, Kayseri, Turkey.
authors.forename: Mahmut
authors.initials: M
authors.lastname: Akpek
authors.affiliation: Department of Cardiology, School of Medicine, Erciyes University, Kayseri, Turkey.
authors.forename: Mehmet  G
authors.initials: M
authors.lastname: Kaya
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D018501:Antirheumatic Agents / Q000494:pharmacology*; D001026:Coronary Artery Bypass / Q000379:methods; D019610:Cytoprotection; D048909:Diabetes Complications / Q000188:drug therapy*; D003920:Diabetes Mellitus; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012294:Rifamycins / Q000494:pharmacology*; D012307:Risk Factors; D013249:Sternum / Q000601:surgery; D016896:Treatment Outcome; D014946:Wound Infection / Q000188:drug therapy*
chemical_list: D018501:Antirheumatic Agents; D012294:Rifamycins; C023808:rifamycin SV