Adjuvant treatment of deep sternal wound infection with collagenous gentamycin

Background. The treatment of deep sternal wound infections remains controve rsial. Currently advocated procedures carry the risk of reinfections. The s ignificance of local antibiotic-releasing systems as an adjuvant therapy to avoid reinfections is the subject of the presented study. Methods. Forty-two patients with deep sternal wound complication were treat ed with radical wound debridement, sternal refixation, retrosternal suction drainage, bilateral pectoralis major muscle flaps, and placement of collag enous drug carrier loaded with gentamycin (Sul-mycin Implant) underneath, a bove, and between the sternal edges. Results. No treatment failure and death were observed in our patients. Side effects after adjuvant treatment with collagenous gentamycin were not dete cted. Conclusions. The preliminary results of adjuvant therapy with collagenous g entamycin in combination with surgical debridement leads to excellent resul ts in the treatment of early deep sternal wound infections with no death an d no primary treatment failures. This technique is easy to perform, reliabl e, and safe. For final judgment controlled randomized trials are mandatory. (C) 1999 by The Society of Thoracic Surgeons.