Abstract
Background
This study aimed to evaluate whether the combined use of gentamicin–collagen sponges
and topical vancomycin reduces the incidence of sternal wound infections (SWIs) in
patients at high risk for infection following cardiac surgery.
Methods
A single-center, retrospective study compared two groups of high-risk cardiac surgery
patients from June 2018 to September 2021. High-risk patients, identified through
departmental consensus, had multiple SWI risk factors. The study group (278 patients)
received gentamicin–collagen sponges plus topical vancomycin, whereas the control
group (309 patients) received only topical vancomycin. The primary outcome was SWI
incidence.
Results
The incidence of SWI was significantly lower in the study group, with 2.8% (8/278)
compared with 9% (28/309) in the control group (p = 0.002). After adjusting for known risk factors, the odds of infection in the control
group were 4.64 times higher (95% confidence interval [CI]: 1.63–13.21) than in the
study group. The rate of deep sternal wound infections (DSWI) was 1.8% in the study
group versus 4.2% in the control group (p = 0.09), with adjusted odds of DSWI being 4.1 times higher in the control group (95%
CI: 0.99–16.86). Although the p-value was borderline (p = 0.05), no significant differences in mortality rates were observed between the
two groups.
Conclusion
The use of gentamicin–collagen sponges as part of a prophylactic regimen significantly
reduces the incidence of SWI in high-risk cardiac surgery patients, suggesting its
potential benefit as an adjunctive treatment in preventing postoperative infections.
Keywords
gentamicin–collagen sponges - gentamicin-containing collagen implants - topical vancomycin
- surgical site infection - sternal wound infection - deep sternal wound infection
