The role of topical Genta Fleece HD and gentamicin spray in prevention of sternum wound infections after open heart surgery: a comparative study

INTRODUCTION: The aim was to clarify and compare the efficacy of local Genta Fleece HD (GF) and topical gentamicin spray (GS) in prevention of wound infections by comparing their results with a control group. MATERIAL AND METHODS: In this retrospective study, charts of patients who underwent coronary artery bypass grafting in a tertiary academic center between January 2015 and January 2017 were analyzed. Patients were divided into three groups: patients in whom GF was applied, patients in whom GS was applied, and a control group in which no additional material was applied. All patients received intravenous antibiotic prophylaxis. Deep and superficial sternal wound infections (SWIs) during the postoperative period were analyzed. RESULTS: The overall infection rate was 13.8% (n = 51). Patients in whom GF was applied had significantly fewer SWIs when compared to the GS group and control group (p = 0.002). A significantly smaller number of deep SWIs occurred in the GS group (7/177; 3.9%) than in the control group (14/125; 11.2%). The superficial SWI rate was significantly lower (2/79; 2.5%) in the GF group than in the other two groups. Duration of hospital stay was significantly shorter in the GF group, followed by the GS and control groups. High EuroSCORE results (≥ 4), obesity (BMI > 30 kg/m(2)), performing the operations under emergency situations and presence of chronic obstructive pulmonary disease were identified as significant risk factors in the development of SWI. CONCLUSIONS: Local GS reduced deep SWIs, whereas GF implantation reduced the overall and superficial SWIs. Also, GF application was superior in terms of reducing the duration of hospital stay.