SURGICAL INFECTIONS OF STERNAL WOUND IN CARDIAC SURGERY PATIENTS TREATED WITH WAX AND VANCOMYCIN PASTE: A SINGLE-CENTER STUDY

Vangel Tomislav Zdraveski; Vesna Velikj Stefanovska; Vasil Papestiev; Marjan Sokarovski; Sasko Jovev; Dejan Dimitrovski; Aleksandar Kolev; Emine Rushiti; Kujtim Xelili

Vangel Tomislav Zdraveski Department of cardiac surgery -University Clinic of State Cardiac Surgery -Skopje, North Macedonia
Vesna Velikj Stefanovska Institute of Epidemiology and Biostatistics, Faculty of Medicine, St. “Cyril and Methodius” University in Skopje, North Macedonia
Vasil Papestiev Department of cardiac surgery - University Clinic of State Cardiac Surgery -Skopje, North Macedonia
Marjan Sokarovski Department of cardiac surgery - University Clinic of State Cardiac Surgery -Skopje, North Macedonia
Sasko Jovev Department of cardiac surgery - University Clinic of State Cardiac Surgery -Skopje, North Macedonia
Dejan Dimitrovski Department of cardiac surgery - University Clinic of State Cardiac Surgery -Skopje, North Macedonia
Aleksandar Kolev Department of cardiac surgery - University Clinic of State Cardiac Surgery -Skopje, North Macedonia
Emine Rushiti Department of cardiac surgery - University Clinic of State Cardiac Surgery -Skopje, North Macedonia
Kujtim Xelili Department of cardiac surgery - University Clinic of State Cardiac Surgery -Skopje, North Macedonia

Abstract

Introduction: Postoperative sternal wound infections are serious and potentially life-threatening complications that are associated with significant morbidity, mortality, and increased health care costs. Although the prophylactic use of topical vancomycin paste to reduce the incidence of deep sternal wound infection, has been repeatedly examined, this method remains controversial.
Material and methods: The research is a retrospective-prospective randomized monocentric clinical study that was conducted in 24 months. We report our first experience with 82 patients operated with a complete medial sternotomy, in which the closure protocol applied intra sternal wax paste in 40 patients, and vancomycin paste in 42 patients. All sternum wound infections that were the result of surgery during this period were analyzed.
Results: Patients in both groups were compared in terms of demographic data and risk factors. In 7 patients operated on with the application of wax paste out of 40 patients, a sternal wound infection developed (17.50%). The introduction of the new protocol for sternal closure with vancomycin paste application reduced this number to 2 patients with superficial sternal wound infection out of 42 patients (4.76%; p<0.001).
Discussion: Topical application of antibiotic agents (vancomycin paste) significantly reduced sternal wound infection. However, the results of this trial need to be confirmed in a randomized trial.
Key words: deep sternal wound infection, topical antibiotic, vancomycin paste, wax paste.

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