Role of Topical Vancomycin Paste in Reduction of Sternal Wound Infections in Cardiac Surgery; A Comparative Study at a Tertiary Care Hospital; Hayatabad Medical Complex, Peshawar
DOI:
https://doi.org/10.47489/szmc.v40i2.950Keywords:
Cardiac surgery, Vancomycin paste, Sternal wound infectionAbstract
Background: Cardiac surgery procedures are labeled as clean procedures, but still these procedures carry a high risk for postoperative infectious complications. For the majority of cardiac procedures median sternotomy is the standard surgical approach, which carries the risk of sternal wound infections (SWI).
Objective: To determine whether applying topical vancomycin paste to the sternal edges following open heart surgery will reduce the rate of sternal wound infections (SWI) or not.
Methods: This quasi experimental study was conducted at the Department of Cardiac Surgery, Hayatabad Medical Complex, Peshawar, from May to October 2025, and included 60 patients planned for open heart surgery. Two equal groups of 30 patients were made. The patients (n=30) in group A received topical vancomycin paste applied to the sternal wound, while patients in group B (n=30) underwent standard sternal wound closure without any topical antimicrobial agents. Postoperatively patients were followed for a period of one month for sternal wound infection . Also the data about major risk factors such as diabetes mellitus (DM), smoking, prolonged cardiopulmonary bypass time (CPB time) and cross clamp time were collected.
Results: Baseline characteristics were comparable between groups. Superficial sternal wound infection was observed in 0% (0/30) of the patients receiving vancomycin paste, whereas 10% patients (3/30) in the routine closure group (p = 0.237) were affected. The risk difference for superficial sternal wound infection was -10% (95% CI: -20.7% to 0.7%). No deep infections occurred in either cohort. All other postoperative outcomes were similar between groups.
Conclusion: Topical vancomycin paste demonstrated a clinically favorable trend with zero superficial sternal wound infections in the treatment group versus 10% in the control group, although this difference did not reach statistical significance (p=0.237) due to the small sample size. The intervention was safe. These findings support the need for adequately powered, multi-center randomized trials to determine definitive efficacy.
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