Syed Tahir Hussain1. 1. Department of Vascular Surgery, Northwick Park University Hospital, Watford Road, Harrow HA1 3UJ, London, United Kingdom. tahirhussain@nhs.net
Abstract
BACKGROUND: The development of surgical site infection (SSI) following vascular surgery is an important issue for healthcare providers as it has serious implications for both patient morbidity and mortality. METHODS: Five publications were identified using the PubMed online database and search terms 'gentamicin-containing collagen implant' plus 'surgical site infection', 'wound infection' and 'vascular surgery'. RESULTS: The reviewed publications demonstrated that prophylactic use of GCCI in conjunction with standard treatment reduces the SSI rate in patients operated on for femeropopliteal bypass grafting. The prophylactic use of GCCI may also have a role to play in patients at high-risk of infection (e.g. in those with co-morbidities such as obesity) and in high-risk procedures (e.g. surgical revision to correct anastomotic aneurysm or dehiscence). GCCI in conjunction with systemic antibiotics may also be effective in the treatment of wound infections of the groin following vascular reconstruction. CONCLUSION: This review demonstrates that GCCI have a role to play in preventing and treating SSI following vascular reconstruction when used in conjunction with standard treatment approaches. Additional randomised, controlled studies are required to further establish the efficacy and cost-effectiveness of GCCI in vascular surgery. Crown
BACKGROUND: The development of surgical site infection (SSI) following vascular surgery is an important issue for healthcare providers as it has serious implications for both patient morbidity and mortality. METHODS: Five publications were identified using the PubMed online database and search terms 'gentamicin-containing collagen implant' plus 'surgical site infection', 'wound infection' and 'vascular surgery'. RESULTS: The reviewed publications demonstrated that prophylactic use of GCCI in conjunction with standard treatment reduces the SSI rate in patients operated on for femeropopliteal bypass grafting. The prophylactic use of GCCI may also have a role to play in patients at high-risk of infection (e.g. in those with co-morbidities such as obesity) and in high-risk procedures (e.g. surgical revision to correct anastomotic aneurysm or dehiscence). GCCI in conjunction with systemic antibiotics may also be effective in the treatment of wound infections of the groin following vascular reconstruction. CONCLUSION: This review demonstrates that GCCI have a role to play in preventing and treating SSI following vascular reconstruction when used in conjunction with standard treatment approaches. Additional randomised, controlled studies are required to further establish the efficacy and cost-effectiveness of GCCI in vascular surgery. Crown