• Krzysztof Kępa, Łukasz Krzych, and Michał Krejca.
• Department of Cardiac Surgery, Medical University of Silesia, Katowice-Ochojec, Poland. Electronic address: kepa.krzysiek@gmail.com.
• Int J Surg. 2015 Jan 1; 13: 198-206.

IntroductionThe majority of evidence for use of gentamicin-containing collagen implants (GCCI) demonstrates a positive impact on infection prophylaxis despite the equivocal results of a recently published large-scale study. The primary aim of the study was to evaluate the impact of prophylactic use of GCCI on SWI following cardiac surgery in a routine clinical setting. A secondary aim was to identify the risk factors for SWI among the patient cohort.MethodsA consecutive series of patients who had undergone sternotomy were analysed on a retrospective basis. Patient characteristics, risk factors and procedure-related variables were analysed for Group I (superficial sternal wound infection [SSWI]) and Group II (deep sternal wound infection [DSWI]) in relation to patients with complete wound healing.ResultsA total of 1118 patients met the inclusion criteria. The bivariate analysis demonstrated that the SSWI rate was significantly reduced by 43% in the GCCI group vs. standard treatment. Multivariate analysis demonstrated that addition of GCCI to standard treatment reduced the DSWI rate by 59% vs. standard treatment alone. Arterial hypertension, permanent/persistent atrial fibrillation and chest revision were identified as new risk factors for SSWI and pulmonary hypertension and chest revision were identified as new risk factors for DSWI.DiscussionThis study confirms the positive results with GCCI seen in the majority of published studies in cardiac surgery.ConclusionIn routine clinical practice the addition of GCCI to standard infection prophylaxis reduces the risk of both SSWI and DSWI in high-risk patients undergoing cardiac surgery.Copyright © 2014 Surgical Associates Ltd. Published by Elsevier Ltd. All rights reserved.

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