Prevention of sternal wound infections with locally administered gentamicin

Despite modern surgical techniques and our knowledge of the pathogenesis of surgical site infections (SSIs) and the use of perioperative antibiotic prophylaxis, the incidence of SSIs has not decreased, but has remained at the same level. More effective preventive methods are thus needed and will likely become even more important in the future due to older and sicker patients, the population becoming increasingly obese, type II diabetes becoming more common, and the emergence of resistant bacteria. The use of local antimicrobial prophylaxis was studied. The study population comprised 557 patients who underwent elective CABG. The patients were randomized and patients in the study group received a 10 cmx10 cm gentamicin-collagen implant. Postoperative SSI occurred in 11 of 272 patients (4.0%) in the study group and in 16 of 270 patients (5.9%) in the control group. This difference was not statistically significant (P=0.20). There were three cases of mediastinitis (1.1%) in the study group and five (1.9%) in the control group (P=0.47).