The Protective Effect of Topical Rifamycin Treatment against Sternal Wound Infection in Diabetic Patients Undergoing on-Pump Coronary Artery Bypass Graft Surgery : Cardiovascular Topic

ABSTRACT

Objectives: The aim of this study was to investigate the protective effect of topical rifamycin SV treatment against sternal wound infection (SWI) in diabetic patients undergoing on-pump coronary artery bypass graft (CABG) surgery. Methods: One hundred and fifty-nine diabetic patients who were scheduled to undergo isolated on-pump CABG surgery were included. Eight were excluded for various reasons. Of the 151 patients; 51 were on insulin therapy and 100 were on oral anti-diabetics. The risk of mediastinitis was assessed using the American College of Cardiology/American Heart Association 2004 guideline update for CABG surgery. According to the risk scores; patients were divided into two comparable groups the rifamycin group (n = 78) received topical rifamycin treatment after on-pump CABG surgery; and the control group (n = 73) received no topical treatment. Results: Deep sternal wound infection (mediastinitis) was not observed in either group (0/78 vs 0/73; p = 1.0). No superficial sternal wound infection was observed in the rifamycin group; however; it did occur in one patient in the control group (0/78 vs 1/73; p = 0.303). Wound culture was performed and coagulase-negative staphylococci were observed. The infection regressed on initiation of antibiotic therapy against isolated bacteria and the patient was discharged after a full recovery. Conclusion: Although the difference in rate of superficial sternal wound infection (SSWI) in the rifamycin and control groups was not statistically significant; locally applied rifamycin SV during closure of the sternum in the CABG operation may have had a protective affect against SWI