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Use of Tropical Vancomycin in Decreasing the Incidence of Surgical Site Infection in Open Heart Surgery

Aim: To study the effect of vancomycin tropically in decreasing the incidence of sternal wound infection in patients undergoing open cardiac surgery. Study design: Randomized controlled trial Place and duration: Department of Cardiovascular & Thoracic Surgery Sheikh Zayed Hospital Lahore from 1st January 2019 to 31st July 2020. Methods: A total of 180 male and female planned for elective open heart surgery is selected for this research work. All patients age is between 40 and 70 years and these patients are bifurcated in two groups. In Group I there are 90 patients in which vancomycin is used on the sternal edges, while in Group II there are 90 patients in which only normal saline wash is used at the time of sternal approximation. At the end incidence of sternal wound infection is monitored to establish the benefits of tropical vancomycin. Results: One hundred and thirty three (73.89%) were males and 47 (26.11%) were females. Topical vancomycin group has decreased rate of superficial and deep sternal wound infections as compared to the patients in which topical vancomycin is not applied (2.22% vs 6.67%) and (1.11% vs 4.4%). Conclusion: Application of vancomycin tropically at surgical site at the time of closure of sternum in conjunction with prophylactic use of antibiotics reduces wound infection in open heart surgery. Keywords: Open heart surgery, Vancomycin, Sternal wound infection