title: Bacterial growth and wound infection following saphenous vein harvesting in cardiac surgery: a randomized controlled trial of the impact of microbial skin sealant.
abstract: The aim of the present study was to compare microbial skin sealant versus bare skin on the leg regarding intraoperative bacterial presence in the surgical wound and time to recolonization of the adjacent skin at the saphenous vein harvesting site. A second aim was to evaluate the incidence of leg wound infection 2 months after surgery. In this randomized controlled trial, 140 patients undergoing coronary artery bypass grafting (CABG) between May 2010 and October 2011 were enrolled. Bacterial samples were taken preoperatively and intraoperatively at multiple time points and locations. OF the patients, 125 (92.6 %) were followed up 2 months postoperatively regarding wound infection. Intraoperative bacterial growth did not differ between the bare skin (n = 68) and the microbial skin sealant group (n = 67) at any time point. At 2 months postoperatively, 7/61 patients (11.5 %) in the skin sealant versus 14/64 (21.9 %) in the bare skin group (p = 0.120) had been treated with antibiotics for a verified or suspected surgical site infection (SSI) at the harvest site. We found almost no intraoperative bacterial presence on the skin or in the subcutaneous tissue, irrespective of microbial skin sealant use. In contrast, we observed a relatively high incidence of late wound infection, indicating that wound contamination occurred postoperatively. Further research is necessary to determine whether the use of microbial skin sealant reduces the incidence of leg wound infection at the saphenous vein harvest site.
authors.affiliation: Department of Cardiothoracic and Vascular Surgery, Örebro University Hospital, Örebro, Sweden, kfb@telia.com.
authors.forename: K
authors.initials: K
authors.lastname: Falk-Brynhildsen
authors.forename: B
authors.initials: B
authors.lastname: Söderquist
authors.forename: O
authors.initials: O
authors.lastname: Friberg
authors.forename: U
authors.initials: U
authors.lastname: Nilsson
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001026:Coronary Artery Bypass / Q000009:adverse effects*; D005260:Female; D006801:Humans; D017053:Infection Control / Q000379:methods*; D008297:Male; D008875:Middle Aged; D011300:Preoperative Care / Q000379:methods*; D012501:Saphenous Vein; D012867:Skin / Q000382:microbiology*; D013530:Surgical Wound Infection / Q000453:epidemiology* / Q000517:prevention & control*; D014947:Wounds and Injuries / Q000382:microbiology*; D055815:Young Adult