title: Gentamicin-containing collagen implant reduces sternal wound complications after cardiac surgery: a retrospective analysis.
abstract: BACKGROUND
  The majority of evidence for use of gentamicin-containing collagen implants (GCCI) demonstrates a positive impact on infection prophylaxis despite the equivocal results of a recently published large-scale study. The primary aim of the study was to evaluate the impact of prophylactic use of GCCI on SWI following cardiac surgery in a routine clinical setting. A secondary aim was to identify the risk factors for SWI among the patient cohort.
  
  
  METHODS
  A consecutive series of patients who had undergone sternotomy were analysed on a retrospective basis. Patient characteristics, risk factors and procedure-related variables were analysed for Group I (superficial sternal wound infection [SSWI]) and Group II (deep sternal wound infection [DSWI]) in relation to patients with complete wound healing.
  
  
  RESULTS
  A total of 1118 patients met the inclusion criteria. The bivariate analysis demonstrated that the SSWI rate was significantly reduced by 43% in the GCCI group vs. standard treatment. Multivariate analysis demonstrated that addition of GCCI to standard treatment reduced the DSWI rate by 59% vs. standard treatment alone. Arterial hypertension, permanent/persistent atrial fibrillation and chest revision were identified as new risk factors for SSWI and pulmonary hypertension and chest revision were identified as new risk factors for DSWI.
  
  
  CONCLUSIONS
  This study confirms the positive results with GCCI seen in the majority of published studies in cardiac surgery.
  
  
  CONCLUSIONS
  In routine clinical practice the addition of GCCI to standard infection prophylaxis reduces the risk of both SSWI and DSWI in high-risk patients undergoing cardiac surgery.
authors.affiliation: Department of Cardiac Surgery, Medical University of Silesia, Katowice-Ochojec, Poland. Electronic address: kepa.krzysiek@gmail.com.
authors.forename: Krzysztof
authors.initials: K
authors.lastname: Kępa
authors.affiliation: Department of Cardiac Anesthesia and Intensive Care, Medical University of Silesia, Silesian Center for Heart Diseases, Zabrze, Poland.
authors.forename: Łukasz
authors.initials: Ł
authors.lastname: Krzych
authors.affiliation: Department of Cardiac Surgery, Medical University of Silesia, Katowice-Ochojec, Poland.
authors.forename: Michał
authors.initials: M
authors.lastname: Krejca
mesh_terms: D000368:Aged; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D019072:Antibiotic Prophylaxis / Q000379:methods*; D006348:Cardiac Surgical Procedures / Q000009:adverse effects*; D003094:Collagen / Q000627:therapeutic use*; D004343:Drug Implants; D005260:Female; D005839:Gentamicins / Q000627:therapeutic use*; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D012189:Retrospective Studies; D012307:Risk Factors; D056346:Sternotomy / Q000009:adverse effects*; D013249:Sternum; D013530:Surgical Wound Infection / Q000517:prevention & control*; D014945:Wound Healing / Q000187:drug effects
chemical_list: D000900:Anti-Bacterial Agents; D004343:Drug Implants; D005839:Gentamicins; D003094:Collagen
keywords: Cardiac surgery; Gentamicin-containing collagen implants; Sternal wound infection; Surgical site infection; Wound infection