Dermacyn irrigation in reducing infection of a median sternotomy wound

Heart Surg Forum. 2010 Aug;13(4):E228-32. doi: 10.1532/HSF98.20091162.

Abstract

Background: Sternal wound infection is an infrequent yet potentially devastating complication following sternotomy. Among the standard practices used as preventive measures are the use of prophylactic antibiotics and povidone-iodine as an irrigation agent. A new antiseptic agent, Dermacyn super-oxidized water (Oculus Innovative Sciences), has recently been used as a wound-irrigation agent before the closure of sternotomy wounds.

Methods: This prospective, randomized clinical trial was conducted to compare the effectiveness of Dermacyn and povidone-iodine in reducing sternotomy wound infection in patients undergoing coronary artery bypass graft surgery. Upon chest closure and after insertion of sternal wires, wounds were soaked for 15 minutes with either Dermacyn or povidone-iodine. Subcutaneous tissue and skin were then closed routinely. Patients were followed up, and any wound infection was analyzed.

Results: Of the 178 patients, 88 patients were in the Dermacyn group, and 90 were in the povidone-iodine group. The mean (+/-SD) age of the patients was 61.1 +/- 7.6 years. The incidence of sternotomy wound infection was 19 cases (10.7%). Five (5.7%) of these cases were from the Dermacyn group, and 14 (15.6%) were from the povidone-iodine group (P = .033). No Dermacyn-related complication was identified.

Conclusion: We found Dermacyn to be safe and more effective as a wound-irrigation agent than povidone-iodine for preventing sternotomy wound infection.

Publication types

  • Comparative Study
  • Randomized Controlled Trial

MeSH terms

  • Aged
  • Anti-Infective Agents, Local / therapeutic use*
  • Bacterial Infections / epidemiology
  • Bacterial Infections / etiology
  • Comorbidity
  • Coronary Artery Bypass / methods
  • Coronary Artery Disease / epidemiology
  • Coronary Artery Disease / surgery
  • Drug Combinations
  • Female
  • Humans
  • Hypochlorous Acid / therapeutic use*
  • Incidence
  • Intensive Care Units
  • Length of Stay
  • Male
  • Middle Aged
  • Povidone-Iodine / therapeutic use*
  • Respiration, Artificial / adverse effects
  • Smoking / adverse effects
  • Sodium Hypochlorite / therapeutic use*
  • Sternotomy / adverse effects*
  • Sternum / surgery*
  • Surgical Wound Infection / epidemiology
  • Surgical Wound Infection / etiology
  • Surgical Wound Infection / microbiology
  • Surgical Wound Infection / prevention & control*
  • Therapeutic Irrigation*
  • Time Factors
  • Treatment Outcome

Substances

  • Anti-Infective Agents, Local
  • Drug Combinations
  • dermacyn
  • Hypochlorous Acid
  • Povidone-Iodine
  • Sodium Hypochlorite