Gentamicin-impregnated collagen sponge for preventing sternal wound infection after cardiac surgery

Kozioł, Małgorzata; Targońska, Sylwia; Stążka, Janusz; Kozioł-Montewka, Maria

doi:10.5114/kitp.2014.41925

Cited by 8 publications

(9 citation statements)

References 19 publications

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“…Our results stay in line with the data provided by the team of Overstreet et al [53] concerning high applicability of local delivery of gentamicin from other types of carriers, namely resorbable viscous hydrogels or with a bulk of clinical evidence presented in the review analysis by Koziol et al [54]. However, the present article is of pilot character, its results confirm the efficacy of high local concentrations of gentamicin released from a sponge carrier against biofilm-forming strains which are classified as resistant according to EUCAST guidelines (especially, if gentamicin’s MIC is close to the EUCAST breakpoint values).…”

Section: Resultssupporting

confidence: 91%

In vitro efficacy of gentamicin released from collagen sponge in eradication of bacterial biofilm preformed on hydroxyapatite surface

et al. 2019

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Biofilm-related infections of bones pose a significant therapeutic issue. In this article we present in vitro results of the efficacy of gentamicin released from a collagen sponge carrier against Staphylococcus aureus , Pseudomonas aeruginosa and Klebsiella pneumoniae biofilms preformed on hydroxyapatite surface. The results indicate that high local concentrations of gentamicin released from a sponge eradicate the biofilm formed not only by gentamicin-sensitive strains but, to some extent, also by those that display a resistance pattern in routine diagnostics. The data presented in this paper is of high clinical translational value and may find application in the treatment of bone infections.

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Section: Resultssupporting

confidence: 91%

In vitro efficacy of gentamicin released from collagen sponge in eradication of bacterial biofilm preformed on hydroxyapatite surface

et al. 2019

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“…Every different position of the GICS corresponds to a slightly different spatial distribution of gentamicin, according to the closest sternal region. 28 , 29 For instance, when a GICS was placed posteriorly to the sternum, its effect was more evident in preventing DSWI rather than SSWI. 30 …”

Section: Pharmacokinetics Of Gicsmentioning

confidence: 99%

Gentamicin-Impregnated Collagen Sponge: Effectiveness in Preventing Sternal Wound Infection in High-Risk Cardiac Surgery

Rapetto

Bruno

Guida

et al. 2016

Drug Target Insights

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Sternal wound infections represent one of the most frequent complications after cardiac surgery and are associated with high postoperative mortality. Several preventive methods have been introduced, and recently, gentamicin-impregnated collagen sponges (GICSs) have shown a promising effect in reducing the incidence of this type of complications. Gentamicin is an aminoglycoside antibiotic that has been widely used to treat infections caused by multiresistant bacteria; despite its effectiveness, its systemic use carries a risk of toxicity. GICSs appear to overcome this side effect, topically delivering high antibiotic concentrations to the wound and thus reducing the toxic-related events. Although several retrospective analyses and randomized controlled trials have studied the use of GICSs in cardiac surgery, conclusions regarding their efficacy in preventing sternal wound infection are inconsistent. We have reviewed the current literature focusing on high-risk patients.

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“…The incidence of DSWI as reported in the literatures is between 0.2-3.6% [1,13,14] and this can be higher especially when the following risk factors like age, diabetes mellitus, obesity, Hypertension, postoperative mechanical ventilation, and early surgical re-exploration, and some surgical techniques such as double harvest of Internal thoracic artery(ITA) in pedicled fashion ;combined valve and coronary artery bypass graft are adopted [15]. In the preoperative period, parameters like diabetes mellitus, COPD and preoperative renal insufficiency were independent risk factors for postoperative sternal complications [16,17]. The prolonged hospital stay and attended escalated cost as notable morbidities.…”

Section: The Epidemiologymentioning

confidence: 99%

The Conundrums of Defect Management in Deep Sternal Wound Infection: Review

Okonta¹

2013

Surgery Curr Res

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Deep Sternal Wound Infection (DWSI) remains an important cause of morbidity and mortality following Cardiac surgery. Equally many methods of preventing it from occurring have been stated however when it does occur, the management by debridement and provision of cover for the defect can be challenging and thus different treatment options are instituted with various degrees of success. The use of Vacuum Assisted Closure therapy was stated as been mere effective in treatment of DSWI with mechanism not known but better used as an adjunct to flaps and with a potential for profuse bleeding. The major advantage in the use of Pectoralis Major Flap was in its bulky size that allows for the cover of defect following sternectomy. However, it had a serious draw back in neonates and infants as the compressive effect on the heart and the distortion of the mammary line and its preclusion in patients with previous radionecrosis and the divergent opinions for further resternontomy. The omental flap has the advantage of provision of cover as may be occasioned by deep defect; in extensive sepsis because of the immunogenic functions and does not lead to deformity but serious complications as the herniation of the transverse colon as an important drawback to its use.This present review gives the omental flap a slight superior edge over the other two when considering the cover for defect; taking care of local sepsis and resternotomy. However, what is needed now is a multicenter randomised study to determine the option that best suit this condition.

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Gentamicin-impregnated collagen sponge for preventing sternal wound infection after cardiac surgery

Cited by 8 publications

References 19 publications

In vitro efficacy of gentamicin released from collagen sponge in eradication of bacterial biofilm preformed on hydroxyapatite surface

In vitro efficacy of gentamicin released from collagen sponge in eradication of bacterial biofilm preformed on hydroxyapatite surface

Gentamicin-Impregnated Collagen Sponge: Effectiveness in Preventing Sternal Wound Infection in High-Risk Cardiac Surgery

The Conundrums of Defect Management in Deep Sternal Wound Infection: Review

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