Harold L Lazar1, Ara Ketchedjian2, Miguel Haime2, Karl Karlson2, Howard Cabral3. 1. Division of Cardiac Surgery, Boston Medical Center and the Boston University School of Medicine, Boston, Mass. Electronic address: harold.lazar@bmc.org. 2. Division of Cardiac Surgery, Boston Medical Center and the Boston University School of Medicine, Boston, Mass. 3. Department of Biostatistics, Boston University School of Public Health, Boston, Mass.
Abstract
OBJECTIVE: This study was undertaken to determine whether topical vancomycin would further reduce the incidence of sternal infections in the presence of perioperative antibiotics and tight glycemic control. METHODS: A total of 1075 consecutive patients undergoing cardiac surgery from December 2007 to August 2013 receiving topical vancomycin (2.5 g in 2 mL of normal saline) applied as a slurry to the cut edges of the sternum were compared with 2190 patients from December 2003 to November 2007 who did not receive topical vancomycin. All patients received perioperative antibiotics (cefazolin 2 g intravenously every 8 hours and vancomycin 1 g intravenously every 12 hours) on induction of anesthetic and continuing for 48 hours; and intravenous insulin infusions to maintain serum blood glucose level between 120 and 180 mg/dL. RESULTS: Patients receiving topical vancomycin had less superficial sternal infections (0% vs 1.6%; P < .0001), deep sternal infections (0% vs 0.7%; P = .005), any type of sternal infection (0% vs 2.2%; P < .0001) and significantly less sternal infections of any type in patients with diabetes mellitus (0% vs 3.3%; P = .0004). CONCLUSIONS: Topical vancomycin applied to the sternal edges, in conjunction with perioperative antibiotics and tight glycemic control, helps to eliminate wound infections in cardiac surgical patients.
OBJECTIVE: This study was undertaken to determine whether topical vancomycin would further reduce the incidence of sternal infections in the presence of perioperative antibiotics and tight glycemic control. METHODS: A total of 1075 consecutive patients undergoing cardiac surgery from December 2007 to August 2013 receiving topical vancomycin (2.5 g in 2 mL of normal saline) applied as a slurry to the cut edges of the sternum were compared with 2190 patients from December 2003 to November 2007 who did not receive topical vancomycin. All patients received perioperative antibiotics (cefazolin 2 g intravenously every 8 hours and vancomycin 1 g intravenously every 12 hours) on induction of anesthetic and continuing for 48 hours; and intravenous insulin infusions to maintain serum blood glucose level between 120 and 180 mg/dL. RESULTS:Patients receiving topical vancomycin had less superficial sternal infections (0% vs 1.6%; P < .0001), deep sternal infections (0% vs 0.7%; P = .005), any type of sternal infection (0% vs 2.2%; P < .0001) and significantly less sternal infections of any type in patients with diabetes mellitus (0% vs 3.3%; P = .0004). CONCLUSIONS: Topical vancomycin applied to the sternal edges, in conjunction with perioperative antibiotics and tight glycemic control, helps to eliminate wound infections in cardiac surgical patients.
Authors: Michał Pasierski; Kamil Zieliński; Giuseppe Maria Raffa; Harold Lazar; Roberto Lorusso; Piotr Suwalski; Mariusz Kowalewski Journal: J Thorac Dis Date: 2019-09 Impact factor: 2.895
Authors: Kingsley O Abode-Iyamah; Hsiu-Yin Chiang; Nolan Winslow; Brian Park; Mario Zanaty; Brian J Dlouhy; Oliver E Flouty; Zachary D Rasmussen; Loreen A Herwaldt; Jeremy D Greenlee Journal: J Neurosurg Date: 2017-05-12 Impact factor: 5.115
Authors: Mohammad Abd Alkhalik Basha; Dina Said Shemais; Essam Saad Abdelwahed; Rabab Mahmoud Elfwakhry; Ayman Fathy Zeid; Ahmed A El-Hamid M Abdalla; Sameh Abdelaziz Aly; Dalia Said Abdelrahman; Anwar A Elshenawy; Waleed Mansour; Khaled Ahmed Ahmed Elbanna; Mohammad El Tahlawi; Nezar Elnahal Journal: Int J Gen Med Date: 2021-12-02