Vancomycin in the prevention of mediastinitis
DOI:
https://doi.org/10.61695/rcs.v2i2.42Keywords:
Mediastinitis, vancomycin, cardiovascular surgery, sternal dehiscence, prophylaxisAbstract
Introduction: Mediastinitis and sternal dehiscence are serious complications in patients submitted to sternotomy, with increasing morbidity and mortality. The incidence varies (0.15 to 8%) and occurs between the 10th and 20th postoperative days. Topical vancomycin at the borders of the sternum seems to reduce the incidence of sternal infection, but may favor the emergence of antibiotic resistance and nephrotoxicity. Objective: To evaluate the topical use of vancomycin as prophylaxis for superficial or deep infection in patients submitted to median sternotomy. Methods: A prospective study with retrospective data collection, where 196 patients submitted to median sternotomy were divided into two groups: group A (101 patients) did not use topical vancomycin and group B (95 patients) used topical vancomycin, applied to the sternal bone after sternotomy and before sternal closure. We define it as superficial infection when it does not reach the sternum and deep when it reaches steel wires, sternum or presents retrosternal fluid collection. Results: The surgical characteristics of the groups did not differ. In group B, there was no superficial or deep infection. Seven patients from group A had sternal infection (7% – p < 0.03), with six cases of mediastinitis (6% – p < 0.05). In the series studied, there was no mortality. Conclusion: In the series studied, use of vancomycin showed bacteriostatic and bactericidal ability to avoid sternal infection.
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Copyright (c) 2024 Helmgton Souza, Beatriz Estrella Souza, Isaac Azevedo Silva, Marcus Vinícius Santos, Glauco Kalil Pina, Ricardo Barros Corso
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