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Collagen-gentamicin implant for prevention of sternal wound infection; long-term follow-up of effectiveness
Örebro University Hospital, Örebro, Sweden.
Linköping University, Department of Medical and Health Sciences, Thoracic Surgery. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Heart Centre, Department of Thoracic and Vascular Surgery.
Örebro University Hospital, Örebro, Sweden.
Linköping University, Department of Clinical and Experimental Medicine, Clinical Microbiology. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Centre for Laboratory Medicine, Department of Clinical Microbiology.
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2009 (English)In: Interactive Cardiovascular and Thoracic Surgery, ISSN 1569-9293, E-ISSN 1569-9285, Vol. 9, no 3, 454-458 p.Article in journal (Refereed) Published
Abstract [en]

In a previous randomized controlled trial (LOGIP trial) the addition of local collagen-gentamicin reduced the incidence of postoperative sternal wound infections (SWI) compared with intravenous prophylaxis only. Consequently, the technique with local gentamicin was introduced in clinical routine at the two participating centers. The aim of the present study was to re-evaluate the technique regarding the prophylactic effect against SWI and to detect potential shifts in causative microbiological agents over time. All patients in this prospective two-center study received prophylaxis with application of two collagen-gentamicin sponges between the sternal halves in addition to routine intravenous antibiotics. All patients were followed for 60 days postoperatively. From January 2007 to May 2008, 1359 patients were included. The 60-day incidences of any SWI was 3.7% and of deep SWI 1.5% (1.0% mediastinitis). Both superficial and deep SWI were significantly reduced compared with the previous control group (OR=0.34 for deep SWI, Pless than0.001). There was no increase in the absolute incidence of aminoglycoside resistant agents. The majority of SWI were caused by coagulase-negative staphylococci (CoNS). The incidence of deep SWI caused by Staphylococcus aureus was 0.07%. The results indicate a maintained effect of the prophylaxis over time without absolute increase in aminoglycoside resistance.

Place, publisher, year, edition, pages
Oxford University Press, 2009. Vol. 9, no 3, 454-458 p.
Keyword [en]
Antibiotics; Cardiac surgery; Complications; Mediastinitis; Regression analysis; Risk factors; Statistics; Wound infection
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URN: urn:nbn:se:liu:diva-21243DOI: 10.1510/icvts.2009.207514PubMedID: 19541691OAI: diva2:240994
Available from: 2009-09-30 Created: 2009-09-30 Last updated: 2015-11-17Bibliographically approved

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Dahlin, Lars-GöranKihlström, ErikSvedjeholm, Rolf
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Thoracic SurgeryFaculty of Health SciencesDepartment of Thoracic and Vascular SurgeryClinical MicrobiologyDepartment of Clinical Microbiology
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Interactive Cardiovascular and Thoracic Surgery

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