A prospective randomized study that compares three different dressings for the prevention of surgical site infections following major heart surgery
Abstract Surgical site infection (SSI) is among the most common complication of major heart surgery patients with incidences ranging from 0.5 to 16.5%. Our aim was to compare the incidence, etiology and prognosis of surgical wound infection in three groups of patients with three different type of wo...
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Nature Portfolio
2025-06-01
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| Online Access: | https://doi.org/10.1038/s41598-025-02533-7 |
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| author | María Jesús Pérez-Granda Gregorio Cuerpo José María Barrio Maricela Valerio Patricia Muñoz Ángel González Pinto Dominique Encarnación Valencia Félix Sánchez Vicario Emilio Bouza Cardiovascular Infection Study Group |
| author_facet | María Jesús Pérez-Granda Gregorio Cuerpo José María Barrio Maricela Valerio Patricia Muñoz Ángel González Pinto Dominique Encarnación Valencia Félix Sánchez Vicario Emilio Bouza Cardiovascular Infection Study Group |
| author_sort | María Jesús Pérez-Granda |
| collection | DOAJ |
| description | Abstract Surgical site infection (SSI) is among the most common complication of major heart surgery patients with incidences ranging from 0.5 to 16.5%. Our aim was to compare the incidence, etiology and prognosis of surgical wound infection in three groups of patients with three different type of wound dressing used in a large cohort of patients undergoing cardiac surgery requiring median sternotomy (MHS). This was a randomized, prospective clinical study conducted in 900 adults undergoing MHS at our center from October 10, 2019 to February 22, 2022. Before surgical closure, patients were randomized to 3 different wound dressing groups (300 patients per group): A) conventional gauze (Mepore®), B) Absorbent: polyurethane foam (Mepilex®), or C) Vacuum-negative-pressure therapy (NPWT) wound dressing (PICO®, Smith & Nephew S.A.). Overall, 900 patients were randomized as follows: 300 patients in each group received conventional, absorbent or vacuum wound dressing respectively. Rates of SSI in groups A, B and C were respectively 2.3%, 3% and 3% for superficial SSI (sSSI) (p = 0.848) and 2%, 2% and 0.7% for postsurgical mediastinitis (PSM) (p = 0.313). Mortality in the whole group was 4.4% there being no significant differences between the three groups (4.7%, 5.7% and 3% respectively; p = 0.277). The NPWT system was better at preventing PSM than the other dressings only in the subgroup of patients undergoing coronary artery bypass graft surgery (CABG) with mammary artery grafts. We have not been able to demonstrate significant differences in the incidence of SSI in the whole series with any of the different dressings. The newer, more expensive, NPWT dressing were more effective only at preventing Post-Surgical Mediastinitis in patients undergoing CABG with internal mammary artery grafts. ClinicalTrials.gov identifier (NCT number): NCT03905213 |
| format | Article |
| id | doaj-art-a6bf567e14bb46598725da9ee1e6189c |
| institution | OA Journals |
| issn | 2045-2322 |
| language | English |
| publishDate | 2025-06-01 |
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| spelling | doaj-art-a6bf567e14bb46598725da9ee1e6189c2025-08-20T02:30:46ZengNature PortfolioScientific Reports2045-23222025-06-0115111110.1038/s41598-025-02533-7A prospective randomized study that compares three different dressings for the prevention of surgical site infections following major heart surgeryMaría Jesús Pérez-Granda0Gregorio Cuerpo1José María Barrio2Maricela Valerio3Patricia Muñoz4Ángel González Pinto5Dominique Encarnación Valencia6Félix Sánchez Vicario7Emilio Bouza8Cardiovascular Infection Study GroupClinical Microbiology and Infectious Diseases Department, Hospital General Universitario Gregorio MarañónDepartment of Cardiac Surgery, Hospital General Universitario Gregorio MarañónCIBER de Enfermedades Respiratorias-CIBERES (CB06/06/0058)Clinical Microbiology and Infectious Diseases Department, Hospital General Universitario Gregorio MarañónClinical Microbiology and Infectious Diseases Department, Hospital General Universitario Gregorio MarañónDepartment of Cardiac Surgery, Hospital General Universitario Gregorio MarañónDepartment of Cardiac Surgery, Hospital General Universitario Gregorio MarañónDepartment of Cardiac Surgery, Hospital General Universitario Gregorio MarañónCIBER de Enfermedades Respiratorias-CIBERES (CB06/06/0058)Abstract Surgical site infection (SSI) is among the most common complication of major heart surgery patients with incidences ranging from 0.5 to 16.5%. Our aim was to compare the incidence, etiology and prognosis of surgical wound infection in three groups of patients with three different type of wound dressing used in a large cohort of patients undergoing cardiac surgery requiring median sternotomy (MHS). This was a randomized, prospective clinical study conducted in 900 adults undergoing MHS at our center from October 10, 2019 to February 22, 2022. Before surgical closure, patients were randomized to 3 different wound dressing groups (300 patients per group): A) conventional gauze (Mepore®), B) Absorbent: polyurethane foam (Mepilex®), or C) Vacuum-negative-pressure therapy (NPWT) wound dressing (PICO®, Smith & Nephew S.A.). Overall, 900 patients were randomized as follows: 300 patients in each group received conventional, absorbent or vacuum wound dressing respectively. Rates of SSI in groups A, B and C were respectively 2.3%, 3% and 3% for superficial SSI (sSSI) (p = 0.848) and 2%, 2% and 0.7% for postsurgical mediastinitis (PSM) (p = 0.313). Mortality in the whole group was 4.4% there being no significant differences between the three groups (4.7%, 5.7% and 3% respectively; p = 0.277). The NPWT system was better at preventing PSM than the other dressings only in the subgroup of patients undergoing coronary artery bypass graft surgery (CABG) with mammary artery grafts. We have not been able to demonstrate significant differences in the incidence of SSI in the whole series with any of the different dressings. The newer, more expensive, NPWT dressing were more effective only at preventing Post-Surgical Mediastinitis in patients undergoing CABG with internal mammary artery grafts. ClinicalTrials.gov identifier (NCT number): NCT03905213https://doi.org/10.1038/s41598-025-02533-7Surgical wound infectionMajor heart surgeryPrevention |
| spellingShingle | María Jesús Pérez-Granda Gregorio Cuerpo José María Barrio Maricela Valerio Patricia Muñoz Ángel González Pinto Dominique Encarnación Valencia Félix Sánchez Vicario Emilio Bouza Cardiovascular Infection Study Group A prospective randomized study that compares three different dressings for the prevention of surgical site infections following major heart surgery Scientific Reports Surgical wound infection Major heart surgery Prevention |
| title | A prospective randomized study that compares three different dressings for the prevention of surgical site infections following major heart surgery |
| title_full | A prospective randomized study that compares three different dressings for the prevention of surgical site infections following major heart surgery |
| title_fullStr | A prospective randomized study that compares three different dressings for the prevention of surgical site infections following major heart surgery |
| title_full_unstemmed | A prospective randomized study that compares three different dressings for the prevention of surgical site infections following major heart surgery |
| title_short | A prospective randomized study that compares three different dressings for the prevention of surgical site infections following major heart surgery |
| title_sort | prospective randomized study that compares three different dressings for the prevention of surgical site infections following major heart surgery |
| topic | Surgical wound infection Major heart surgery Prevention |
| url | https://doi.org/10.1038/s41598-025-02533-7 |
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