Topical Gentamicin and Vancomycin for Surgical Site Infection Prophylaxis in Patients 5. Undergoing High-Risk Vascular Surgery
Abstract
Introduction: Arterial surgery using a groin incision has a high incidence of surgical site infection (SSI), which is morbid and costly. Gentamicin-eluting collagen sponges and vancomycin powder are effective SSI prophylaxis for nonvascular operations. Feasibility of a prospective trial of SSI incidence after high-risk arterial surgery with topical gentamicin and vancomycin was assessed.
Methods: A randomized controlled feasibility trial enrolling 32 patients with ≥1 of obesity, diabetes, reoperation, tissue loss or dialysis. In 41 groin incisions, 21 had standard closure and 20 had closure with topical gentamicin and vancomycin. Primary feasibility outcomes and secondary clinical outcomes were recorded at 90 days.
Results: Feasibility was achieved in all metrics. SSI was reported in 13 patients (31.7%), 8 (38.1%) standard and 5 (25.0%) experimental patients.
Conclusion: Gentamicin-eluting collagen sponge and vancomycin powder use in high-risk groin incisions is feasible for study. There was a trend towards fewer infections in the experimental arm.