Adjuvant treatment of deep sternal wound infection with collagenous gentamycin

Background. The treatment of deep sternal wound infections remains controversial. Currently advocated procedures carry the risk of reinfections. The significance 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 treated with radical wound debridement, sternal refixation, retrosternal suction drainage, bilateral pectoralis major muscle flaps, and placement of collagenous drug carrier loaded with gentamycin (Sul-mycin Implant) underneath, above, 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 detected. Conclusions. The preliminary results of adjuvant therapy with collagenous gentamycin in combination with surgical debridement leads to excellent results in the treatment of early deep sternal wound infections with no death and no primary treatment failures. This technique is easy to perform, reliable, and safe. For final judgment controlled randomized trials are mandatory. (C) 1999 by The Society of Thoracic Surgeons.