The role of topical Genta Fleece HD and gentamicin spray in prevention of sternum wound infections after open heart surgery: a comparative study.

INTRODUCTION

The aim was to clarify and compare the efficacy of local Genta Fleece HD (GF) and topical gentamicin spray (GS) in prevention of wound infections by comparing their results with a control group.

MATERIAL AND METHODS

In this retrospective study, charts of patients who underwent coronary artery bypass grafting in a tertiary academic center between January 2015 and January 2017 were analyzed. Patients were divided into three groups: patients in whom GF was applied, patients in whom GS was applied, and a control group in which no additional material was applied. All patients received intravenous antibiotic prophylaxis. Deep and superficial sternal wound infections (SWIs) during the postoperative period were analyzed.

RESULTS

The overall infection rate was 13.8% ( = 51). Patients in whom GF was applied had significantly fewer SWIs when compared to the GS group and control group ( = 0.002). A significantly smaller number of deep SWIs occurred in the GS group (7/177; 3.9%) than in the control group (14/125; 11.2%). The superficial SWI rate was significantly lower (2/79; 2.5%) in the GF group than in the other two groups. Duration of hospital stay was significantly shorter in the GF group, followed by the GS and control groups. High EuroSCORE results (≥ 4), obesity (BMI > 30 kg/m), performing the operations under emergency situations and presence of chronic obstructive pulmonary disease were identified as significant risk factors in the development of SWI.

CONCLUSIONS

Local GS reduced deep SWIs, whereas GF implantation reduced the overall and superficial SWIs. Also, GF application was superior in terms of reducing the duration of hospital stay.