학술논문
Regional antibiotic delivery for sternal wound infection prophylaxis a systematic review and meta-analysis of randomized controlled trials
Document Type
article
Author
Mariusz Kowalewski; Michalina M. Kołodziejczak; Tomasz Urbanowicz; Maria Elena De Piero; Silvia Mariani; Michał Pasierski; Maged Makhoul; Maria Comanici; Emil Julian Dąbrowski; Matteo Matteucci; Giulio Massimi; Radosław Litwinowicz; Adam Kowalówka; Wojciech Wańha; Federica Jiritano; Gennaro Martucci; Giuseppe Maria Raffa; Pietro Giorgio Malvindi; Łukasz Kuźma; Piotr Suwalski; Roberto Lorusso; Paolo Meani; Harold Lazar; Thoracic Research Centre
Source
Scientific Reports, Vol 14, Iss 1, Pp 1-13 (2024)
Subject
Language
English
ISSN
2045-2322
Abstract
Abstract Despite evidence suggesting the benefit of prophylactic regional antibiotic delivery (RAD) to sternal edges during cardiac surgery, it is seldom performed in clinical practice. The value of topical vancomycin and gentamicin for sternal wound infections (SWI) prophylaxis was further questioned by recent studies including randomized controlled trials (RCTs). The aim of this systematic review and meta-analysis was to comprehensively assess the safety and effectiveness of RAD to reduce the risk of SWI.We screened multiple databases for RCTs assessing the effectiveness of RAD (vancomycin, gentamicin) in SWI prophylaxis. Random effects meta-analysis was performed. The primary endpoint was any SWI; other wound complications were also analysed. Odds Ratios served as the primary statistical analyses. Trial sequential analysis (TSA) was performed.Thirteen RCTs (N = 7,719 patients) were included. The odds of any SWI were significantly reduced by over 50% with any RAD: OR (95%CIs): 0.49 (0.35–0.68); p