title: Novel Method of Infection Prophylaxis in Heart Transplantation by Retrosternal Gentamycin Sponge Application.
abstract: BACKGROUND
  Surgical wound infections are more frequent in patients undergoing heart transplantation than in other heart surgery patients. There is a wide spread of sternal wound infection incidence in transplant patients ranging from 4% to 40%. It is first study describing local gentamicin sponge application during heart transplantation procedure.
  
  
  METHODS
  We enrolled 75 patients in a retrospective, single-center study, including 25 patients who underwent orthotopic heart transplantation (heart transplant group) and 50 in the cardiac surgery group. They were in mean age of 49 ± 12 years and 51 ± 13 years in heart transplantation and cardiac surgery group, respectively. A gentamicin sponge was inserted intraoperatively between sternal borders before chest closure in all heart transplantation patients.
  
  
  RESULTS
  There was 1 early death (4%) on postoperative day 7 owing to Clostridium difficile infection in the heart transplant group. There was 1 death (2%) in the cardiac surgery group owing to multiorgan failure secondary to perioperative heart ischemia. There was neither bacterial sternal wound infection nor sternal instability in the heart transplant group. None of the patients who had gentamicin sponge applied had wound healing problems. Two patients (4%) had a deep sternal wound infection in the cardiac surgery group, who had no sponge application; 1 (2%) was treated by surgical debridement and active drainage and 1 (2%) by vacuum therapy. There were 11 patients (44%) discharged on insulin therapy in the heart transplant group and 21 (21%) in the cardiac surgery group. Mean overall postoperative hospital stay was 35 ± 19 days in the heart transplant group and 10 ± 4 days in the cardiac surgery group.
  
  
  CONCLUSIONS
  Gentamicin sponge is an effective local infection prophylaxis in heart transplant patients.
authors: Cardiac Surgery and Transplantology Department, Chair of Cardio-Thoracic Surgery, Poznań University of Medical Sciences, Poznań, Poland. Electronic address: tomasz.urbanowicz@skpp.edu.pl.
authors: T
authors: T
authors: Urbanowicz
authors: Cardiology Department, Poznań University of Medical Sciences, Poznań, Poland.
authors: E
authors: E
authors: Straburzyńska-Migaj
authors: Cardiac Surgery and Transplantology Department, Chair of Cardio-Thoracic Surgery, Poznań University of Medical Sciences, Poznań, Poland.
authors: P
authors: P
authors: Buczkowski
authors: Cardiology Department, Poznań University of Medical Sciences, Poznań, Poland.
authors: S
authors: S
authors: Grajek
authors: Cardiac Surgery and Transplantology Department, Chair of Cardio-Thoracic Surgery, Poznań University of Medical Sciences, Poznań, Poland.
authors: M
authors: M
authors: Jemielity
mesh_terms: D000328:Adult; D000368:Aged; D000818:Animals; D000900:Anti-Bacterial Agents / Q000008:administration & dosage*; D005260:Female; D005839:Gentamicins / Q000008:administration & dosage*; D016027:Heart Transplantation / Q000009:adverse effects / Q000379:methods*; D006801:Humans; D015994:Incidence; D007902:Length of Stay / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D015503:Surgical Sponges; D013530:Surgical Wound Infection / Q000453:epidemiology / Q000209:etiology / Q000517:prevention & control*
chemical_list: D000900:Anti-Bacterial Agents; D005839:Gentamicins