Local collagen‐gentamicin for prevention of sternal wound infections: the LOGIP trial

Friberg, Örjan

doi:10.1111/j.1600-0463.2007.00835.x

Cited by 25 publications

(17 citation statements)

References 19 publications

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“…In the Local Gentamicin for Sternal Wound Infection Prophylaxis (LO-GIP) trial (a prospective randomized controlled trial with 2000 procedures), the placement of collagen-gentamicin sponges (with 260 mg gentamicin) within the sternotomy wound prior to closure reduced infection rates from 9% to 4.3%. 15,16 These findings were confirmed with another prospective randomized controlled trial in 2012 showing infection reduction from 3.5% to 0.56%. 39 However, 2 randomized controlled trials in 2005 and 2010 failed to show a significant change in infection with topical antibiotics.…”

Section: 3046supporting

confidence: 76%

“…Large, prospective, randomized trials have shown that the application of topical gentamicin directly to sternal wounds in cardiac surgery has led to a significant reduction in infection rates. 15,16,39 Similarly, the use of vancomycin powder in posterior spinal fusion for trauma has shown reduced infection rates from as much as 13% to as low as 0%. 17,19 The application of concentrated antibiotics directly to surgical wounds during nonspinal neurosurgical procedures has been more limited.…”

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confidence: 99%

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Reduction in CSF shunt infection over a 10-year period associated with the application of concentrated topical antibiotic powder directly to surgical wounds prior to closure

Beckman

Amankwah²,

Tetreault

et al. 2015

PED

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OBJECT The application of concentrated topical antibiotic powder directly to surgical wounds has been associated with a reduction in wound infection in cardiac, spinal, and deep brain stimulator surgery. As a result of these findings, the corresponding author began systematically applying concentrated bacitracin powder directly to wounds during shunt surgery more than 5 years ago. The object of this study was to evaluate the effectiveness of concentrated bacitracin powder applied directly to wounds prior to closure during cranial shunt surgery and to evaluate the association between shunt infection and other risk factors. A single surgeon’s cranial shunt surgery experience, equally divided between periods during which antibiotic powder was and was not applied, was studied to assess the effect of concentrated bacitracin powder application on shunt infection rates. METHODS This retrospective cohort study included all patients who underwent a cranial shunting procedure at All Children’s Hospital performed by a single surgeon (G.F.T.) from 2001 to 2013. The surgeon applied bacitracin powder to all shunt wounds prior to closure between 2008 and 2013, whereas no antibiotic powder was applied to wounds prior to 2008. Both initial and revision shunting procedures were included, and all procedures were performed at a large children’s hospital (All Children’s Hospital). The primary outcome measure was shunt infection, which was defined using clinical criteria previously used by the Hydrocephalus Clinical Research Network. The association between bacitracin powder use and shunt infection was estimated using hazard ratios (HRs) and 95% CIs from Cox proportional hazard regression models. RESULTS A total of 47 infections out of 539 shunt operations occurred during the study period, resulting in an overall infection rate of 8.7%. Procedures performed before the use of concentrated bacitracin powder was instituted resulted in a 13% infection rate, whereas procedures performed after systematic use of bacitracin powder had been adopted experienced a 1% infection rate. Bacitracin powder use was associated with a reduced risk of shunt infection in univariate analysis (HR 0.11, 95% CI 0.03–0.34, p = 0.0002) and also in multivariate analysis (HR 0.12, 95% CI 0.04–0.41, p = 0.0006) when controlling for covariates that were associated with infection from the univariate analysis. The presence of a tracheostomy or a gastrostomy tube was also found to be independently associated with shunt infection in multivariate analysis (HR 3.15, 95% CI 1.05–9.50, p = 0.04, and HR 2.82, 95% CI 1.33–5.96, p = 0.007, respectively). CONCLUSIONS This study suggests, for the first time, that the systematic application of concentrated bacitracin powder to surgical wounds prior to closure during shunt surgery may be associated with a reduction in cranial shunt infection. This initial finding requires validation in a large prospective study before widespread application can be advocated.

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Section: 3046supporting

confidence: 76%

mentioning

confidence: 99%

Reduction in CSF shunt infection over a 10-year period associated with the application of concentrated topical antibiotic powder directly to surgical wounds prior to closure

Beckman

Amankwah²,

Tetreault

et al. 2015

PED

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“…The difference in all groups involving deep SSI was not of statistical significance, except in groups of patients with a BMI>25 kg/m 2 and/or diabetes mellitus [10,12]. On the other hand, there were significantly more reoperations for bleeding in the gentamicin-collagen group (4.0 % vs. 2.3 %).…”

Section: Discussionmentioning

confidence: 79%

“…Most published articles involving topicallyadministered gentamicin with a collagen carrier describe results of the prophylaxis of SSI in a cardiac surgery [5][6][7][8][9][10][11]. Gentamicin-collagen implants of various brand names (Collatamp-G ® , Gentacoll ® , Sulmycin Implant ® ) that contain 130 mg of gentamicin and 280 mg of collagen were put underneath the sternum or between its edges before sternotomy closure.…”

Section: Discussionmentioning

confidence: 99%

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TOPICALLY-USED GENTAMICIN ATTACHED TO NANOFIBRE MDOCTM COMPARED WITH GARAMYCIN SCHWAMM<sup>®</sup> IN AN ACUTE WOUND INFECTION MODEL. AN EXPERIMENTAL STUDY.

Lochman¹,

Páral²,

Simkovĭc³

et al. 2012

MMSL

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SummaryThe aim of this study was to examine the effect of topically-used gentamicin attached to a biodegradable carrier, formed by micro-dispersed oxidised cellulose (MDOC) in nanofibre form, in acute wound infection treatment and to compare it with Garamycin Schwamm ® . Twelve domestic swines were used in a model of a full-thickness infected dermal wound. The effectiveness of both materials in wound infections caused by Staphylococcus aureus, Pseudomonas aeruginosa and Escherichia coli was tested. The effectiveness of both gentamicin with MDOC and Garamycin Schwamm ® was comparable in Pseudomonas aeruginosa and Escherichia coli infections according to microbiological cultures findings. With Staphylococcus aureus infections there was a higher percent of negative cultures when MDOC with gentamicin was administered, but without statistical significance (p=0.069). When macroscopically assesed, 100 % of infected wounds treated by gentamicin attached to MDOC were without signs of local infection compared to only 16.7 % when Garamycin Schwamm ® was used and this was statistically significant (p<0.01). For statistical analysis we used a Fisher´s exact test. When combined with a nanofibre MDOC carrier, topically-used gentamicin seems to be rendered more for treatment of full-thickness skin infections. The resulting good haemostatic effect of MDOC was observed.

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Interventions to prevent surgical site infection in adults undergoing cardiac surgery

Rogers,

Vaja,

Bleetman

et al. 2024

Cochrane Database of Systematic Reviews

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Local collagen‐gentamicin for prevention of sternal wound infections: the LOGIP trial

Cited by 25 publications

References 19 publications

Reduction in CSF shunt infection over a 10-year period associated with the application of concentrated topical antibiotic powder directly to surgical wounds prior to closure

Reduction in CSF shunt infection over a 10-year period associated with the application of concentrated topical antibiotic powder directly to surgical wounds prior to closure

TOPICALLY-USED GENTAMICIN ATTACHED TO NANOFIBRE MDOCTM COMPARED WITH GARAMYCIN SCHWAMM<sup>®</sup> IN AN ACUTE WOUND INFECTION MODEL. AN EXPERIMENTAL STUDY.

Interventions to prevent surgical site infection in adults undergoing cardiac surgery

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