Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 2 de 2
Filtrar
Mais filtros










Base de dados
Intervalo de ano de publicação
2.
Ann Thorac Surg ; 95(4): 1323-9; discussion 1329-30, 2013 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-23462262

RESUMO

BACKGROUND: Internal mammary artery (IMA) harvesting for coronary artery bypass grafting (CABG) influences tissue perfusion and represents a risk factor for deep sternal wound infection (DSWI). Cephalosporins are routinely administered for prophylaxis during cardiac operations to decrease perioperative wound infections. We hypothesized that mammary artery preparation impairs antibiotic penetration into presternal tissue during CABG. METHODS: Eight patients undergoing skeletonized left mammary artery harvesting for CABG were included. Standard antibiotic prophylaxis was administered: 4 g of cefazolin before skin incision and an additional 2 g during skin closure. Concentrations of cefazolin were measured in subcutaneous tissue on the presternal right and left sides (surgically affected) after sternotomy and additionally in subcutaneous tissue on the thigh (surgically unaffected) by microdialysis over a 10-hour period. RESULTS: Mean peak tissue concentration and the area under the curve (AUC) on the left sternal side were significantly reduced compared with the right side and compared with the thigh (mean peak concentration, 13.1±5.8 versus 24.1±4.7 and 27.8±9.7 µg/mL; p=0.005 and p=0.013; AUC 74.2±31.0 versus 110.4±25.0 and 140.3±46.3 µg×hours per milliliter; p=0.004 and p=0.002). Mean subcutaneous concentrations of cefazolin on the left sternal side exceeded the minimal inhibitory concentration (MIC90) of Staphylococcus epidermidis of 4 µg/mL in only 5 of 8 (37.5%) patients after 5 hours. CONCLUSIONS: IMA harvesting significantly impairs local antibiotic penetration during CABG. Common antibiotic dosing schemas should be reevaluated in this cardiac surgical setting.


Assuntos
Antibioticoprofilaxia/métodos , Cefazolina/administração & dosagem , Ponte de Artéria Coronária/métodos , Artéria Torácica Interna/transplante , Esterno/irrigação sanguínea , Infecção da Ferida Cirúrgica/prevenção & controle , Coleta de Tecidos e Órgãos/métodos , Idoso , Antibacterianos/administração & dosagem , Antibacterianos/farmacocinética , Cefazolina/farmacocinética , Relação Dose-Resposta a Droga , Feminino , Seguimentos , Humanos , Masculino , Microdiálise/métodos , Fatores de Risco , Esterno/cirurgia , Infecção da Ferida Cirúrgica/metabolismo , Resultado do Tratamento
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA
...