Effectiveness of Gentamicin-Collagen Sponges in Preventing Sternal Wound Infections.

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, while 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 to 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% 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.

Conclusions: 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 post-operative infections.