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Regional antibiotic delivery for sternal wound infection prophylaxis a systematic review and meta-analysis of randomized controlled trials

Regional antibiotic delivery for sternal wound infection prophylaxis a systematic review and meta-analysis of randomized controlled trials

Authors :
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)
Publication Year :
2024
Publisher :
Nature Portfolio, 2024.

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

Details

Language :
English
ISSN :
20452322
Volume :
14
Issue :
1
Database :
Directory of Open Access Journals
Journal :
Scientific Reports
Publication Type :
Academic Journal
Accession number :
edsdoj.7d4a946fd5924609a665dda55677c509
Document Type :
article
Full Text :
https://doi.org/10.1038/s41598-024-60242-z