Choise of local antibacterial medications for prevention of sternal infection

Abstract

Infection of wounds in surgery is one of the most frequent complications in the postoperative period. The development of this complication increases the duration of hospitalization, resulting in higher treatment costs, as well as the impact to the level of hospital mortality. There are many methods are exist to avoid this complication, which are allow to decontamination of pathogenic and conditionally pathogenic microorganisms including applying antimicrobial agents prior to surgery. One such method is intravenous antibiotic shortly before surgery. But there is evidence in the literature of successful local antibiotics in neurosurgery, traumatology and orthopedics, operations on the thorax and abdominal organs, including for prevention of sternal infection. For this purpose most often used vancomycin and gentamicin. This is often a causative agent of wound infection, which is a gram-positive flora: Staphylococcus aureus and Staphylococcus epidermidis. To increase the effectiveness of preventive measures to reduce the incidence of sternal infection intraoperatively topically applied antibiotics in various forms when closing the wound. For parenteral administration of antibiotics effective therapeutic dose is often not achieved, because it depend on the time period since the introduction of the substance until the start of the operation [3]. Local application of antibiotics to a reduction of frequency wound infection, as concentration of a substance is directly dependent on the applied dose.