Research Article
Volume 5 Issue 8 - 2018
Use of Vancomycin in the Prevention of Superficial and Deep Infections after Sternotomy
JHelmgton JB Souza, Thiago do Amaral Cavalcante, Leonardo Jadyr Silva Rodrigues Alves, Rafael Ramos Amaral, Diogo Assis Souza, Felipe Bruno Santos da Cunha, Henrique Louzan Machado*, Isaac Azevedo Silva, Marcus Vinícius N Santos, Glauco Kalil Pina, Luiz Sérgio Alves-Silva and Ricardo Barros Corso
Department of Medicine, University Center of Brasília, Brasília, Brazil
*Corresponding Author: Henrique Louzan Machado, Department of Medicine, University Center of Brasília, Brasília, Brazil.
Received: April 27, 2018; Published: July 07, 2018
Citation: Henrique Louzan Machado., et al. “Use of Vancomycin in the Prevention of Superficial and Deep Infections after Sternotomy”. EC Cardiology 5.8 (2018): 506-513.
Abstract
Introduction: Mediastinitis and sternal dehiscence are serious complications in patients submitted to sternotomy, with increasing morbidity and mortality. The incidence varies (0.15 to 8%) and occurs between the 10th and 20th postoperative days. Topical vancomycin at the borders of the sternum seems to reduce the incidence of sternal infection but may favour the emergence of antibiotic resistance and nephrotoxicity.
Objective: Mediastinitis and sternal dehiscence are serious complications in patients submitted to sternotomy, with increasing morbidity and mortality. The incidence varies (0.15 to 8%) and occurs between the 10th and 20th postoperative days. Topical vancomycin at the borders of the sternum seems to reduce the incidence of sternal infection but may favour the emergence of antibiotic resistance and nephrotoxicity.
Methods: A prospective study with retrospective data collection, where 196 patients submitted to median sternotomy were divided into two groups: group A (101 patients) did not use topical vancomycin and group B (95 patients) used topical vancomycin, applied to the sternal bone after sternotomy and before sternal closure. We define it as superficial infection when it does not reach the sternum and deep when it reaches steel wires, sternum or presents retrosternal fluid collection.
Results: The surgical characteristics of the groups did not differ. In group B, there was no superficial or deep infection. Seven patients from group A had sternal infection (7% - p < 0.03), with six cases of mediastinitis (6% - p < 0.05). In the series studied, there was no mortality.
Conclusion: In the series studied, use of vancomycin showed bacteriostatic and bactericidal ability to avoid sternal infection.
Keywords: Mediastinitis, Vancomycin, Cardiovascular Surgery, Sternal Dehiscence, Sternal Infection, Prophylaxis
Copyright: © 2018 Henrique Louzan Machado., et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

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