Gentamicin collagen sponges for the prevention of sternal wound infection: A meta-analysis of randomized controlled trials

Mavros, Michael N.; Mitsikostas, Pantelis K.; Alexiou, Vangelis G.; Peppas, George; Falagas, Matthew E.

doi:10.1016/j.jtcvs.2012.06.040

Cited by 42 publications

(32 citation statements)

References 26 publications

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“…[10][11][12][13][14] A recent meta-analysis combining these trials concluded that the risk of deep sternal wound infection was significantly lower in patients who received a gentamicin collagen sponge than in patients who did not (RR, 0.62 [95% CI, 0.39-0.97]) despite significant heterogeneity among the trials. 15 Hence, numerous studies with their significant findings advocate the use of topical antibiotic in reducing the rate of SSSI while others refute the routine use of topical antibiotics.…”

Section: Incidence Of Superficial Surgical Site Infection (Sssi)mentioning

confidence: 99%

Prospective study of surgical site infection in laparotomy wounds with antibiotic lavage

Chatterjee

Khaitan²,

Bhattacharya

et al. 2016

Int Surg J

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Section: Incidence Of Superficial Surgical Site Infection (Sssi)mentioning

confidence: 99%

Prospective study of surgical site infection in laparotomy wounds with antibiotic lavage

Chatterjee

Khaitan²,

Bhattacharya

et al. 2016

Int Surg J

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“…Elles concluent de façon diverse, mais insistent sur l'hétéro-généité entre les études et la nécessité de travaux complémentaires [46,47].…”

Section: Techniques Chirurgicalesunclassified

Infection du site opératoire après chirurgie cardiaque

Pourbaix

Dubert

Lescure

2015

Journal des Anti-infectieux

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“…Mavros et al performed a meta-analysis of randomized controlled trials [76] (Table 1). Four RCTs were considered of high quality (score of 3 or more according to modified Jadad criteria) and were included in the study (4672 patients).…”

Section: Reviewmentioning

confidence: 99%

“…GCCI reduced risk of DSWI (risk ratio, 0.62; 95% confidence interval, 0.39-0.97). However, no benefit was demonstrated regarding superficial sternal wound infections and all-cause mortality [76]. Pooled data from 2 randomized controlled trials (3410 patients), showed that use of GCCI also reduced the need for surgical revision of sternal wounds (risk ratio, 0.59; 95% confidence interval, 0.41-0.86).…”

Section: Reviewmentioning

confidence: 99%

“…Pooled data from 2 randomized controlled trials (3410 patients), showed that use of GCCI also reduced the need for surgical revision of sternal wounds (risk ratio, 0.59; 95% confidence interval, 0.41-0.86). The most commonly isolated pathogens were coagulase-negative Staphylococcus spp (43%) and Staphylococcus aureus (28%) [76]. The authors concluded that there is large statistical heterogeneity among the existing trials and emphasised the need for additional large, high-quality randomized controlled trials [76].…”

Section: Reviewmentioning

confidence: 99%

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Role of topical application of gentamicin containing collagen implants in cardiac surgery

Mishra¹,

Ashoub

Salhiyyah

et al. 2014

J Cardiothorac Surg

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Sternal wound infections (SWI) continue to be a major cause of concern after cardiac surgery. It leads to prolonged hospital stay and increased morbidity, mortality and increased hospital costs. Prophylactic systemic antibiotics have been used to prevent surgical site infection (SSI). However, prolonged postoperative use of systemic antibiotics can lead to emergence of resistant organisms. Gentamycin Containing Collagen Implants (GCCI) when used during sternotomy closure produces high local antibiotic concentrations in the wound with a low serum concentration. There is evidence that the concentration of gentamicin in the mediastinal fluid reaches levels high enough to be effective against bacteria that are considered resistant to gentamycin and other antibiotics.However, questions have been raised about the safety and efficacy of GCCI. There were concerns whether GCCI can lead to systemic absorption with renal impairment and whether use of topical antibiotics can lead to emergence of antimicrobial resistance.We, hereby, review the literature on GCCI (Collatamp) and take the opportunity to appraise the scientific community about their role in cardiac surgery. Several recent studies have supported their clinical effectiveness. They should be used in dry condition and should not be soaked in saline even for a short period prior to use. However, for GCCI to become part of routine practice in cardiac surgery further large randomised studies are required. As the incidence of sternal wound infection is low in the specialty of cardiac surgery, for any study to be sufficiently powered to address this issue, multicenter studies might be the way forward.Based on the evidence presented in this manuscript it is recommended GCCI (Collatamp) can be a cost effective adjunct for prevention of sternal wound infection. They can also be used for treatment of Deep Sternal Wound Infection.

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Gentamicin collagen sponges for the prevention of sternal wound infection: A meta-analysis of randomized controlled trials

Abstract: Gentamicin collagen sponges seem to reduce the sternal wound infection rate in patients undergoing cardiac surgery. The statistical heterogeneity among the existing trials underlines the need for additional large, high-quality randomized controlled trials.

Cited by 42 publications

References 26 publications

Prospective study of surgical site infection in laparotomy wounds with antibiotic lavage

Prospective study of surgical site infection in laparotomy wounds with antibiotic lavage

Infection du site opératoire après chirurgie cardiaque

Role of topical application of gentamicin containing collagen implants in cardiac surgery

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