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Ann Thorac Surg 2005;79:161-162
© 2005 The Society of Thoracic Surgeons

INVITED COMMENTARY

Reida El Oakley, FRCS, MD

Department of Surgery, National University of Singapore, 5 Lower Kent Ridge Rd, Singapore 119074

The first 20% of the full text of this article appears below.

One of the most contentious issues in surgery is the use of prophylactic topical antibiotics to prevent wound infection [1]; cardiac surgery is no exception. Despite regular use of prophylactic intravenous antibiotics, postoperative mediastinitis occurs in a significant number of patients undergoing open heart surgery through median sternototmy. This major complication plagues the most commonly used incision in cardiac surgery, and is associated with a mortality rate as high as 47%. Staphylococcus aureus or S epidermidis are isolated in as many as 70% of the cases. Therefore, prophylactic instillation of antigram-positive antimicrobials during wound closure may reduce the risk of mediastinitis. This concept has indeed been tested in a previous prospective, randomized, controlled study; Vander Salm and associates [2] found that topical vancomycin applied during wound closure after median sternotomy was associated with a significant reduction in the rate of sternal wound infection (from 3.6% in the control group to 0.45% in the treatment group). We found sub-MIC levels . . . [Full Text of this Article]


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Ann. Thorac. Surg. 2005 79: 153-161. [Abstract] [Full Text] [PDF]





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