Early clinical outcomes of routine prophylactic use of a gentamicin-impregnated sponge in all consecutive patients undergoing cardiac surgical operations: a single-center experience.

INTRODUCTION: Surgical site infections (SSIs) are one of the most serious complications in surgery and are associated with significant mortality and morbidity. Prophylactic systemic antibiotics are not completely effective in SSI prevention. AIM: The purpose of this study was to assess outcomes of routine application of a gentamicin-impregnated sponge. MATERIAL AND METHODS: The study involved 363 consecutive patients with a mean age of 62.7 ±12.1 years who underwent cardiac surgical operations from complete or partial midline sternotomy. In group S (n = 196) a gentamicin-impregnated sponge was placed retrosternally. whereas in group C (n = 167) no local antibiotics were used. The other aspects of the perioperative prophylactic protocol were not changed during the study. Postoperative adverse events were assessed with special attention to SSI rate. RESULTS: Patients of both groups were comparable in terms of the majority of pre- and intraoperative variables. The only exception was lower BMI in group S (28.3 ±4.2 kg/m2) than in group C (29.5 ±4.8 kg/m2; p = 0.013); however, prevalence of obese subjects was comparable between groups (36.7% vs. 41.6%, in group S and group C, respectively; ns). Any adverse events in the early postoperative period were more frequent in group C (22.3%) than in group S (19.8%) (p = 0.040), mainly due to SSI rate (4.1% vs. 10.7%) (p = 0.017). Routine application of a gentamicin-impregnated sponge led to a marked reduction in deep SSI rates from 5.4% to 1.5% (p = 0.040) but not in superficial SSI rates (5.4% vs. 2.6%; p = 0.162). CONCLUSIONS: Our study suggested that routine application of a gentamicin-impregnated sponge may be efficacious in prevention of deep wound infection following cardiac surgical procedures irrespective of risk profile.