Antibiotic Beads Perform Well to Prevent Surgical Infection

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Several Trips to the OR, But Excellent Outcomes

Postoperative infection has long been the bane of bypass surgery, especially when prosthetic conduits are used. While excision of the graft and extra-anatomic bypass is feasible, there are many downsides to this approach. More recently, in situ treatment has been promulgated, with methods such as wound vacuum, in situ replacement with antibiotic-bonded or -soaked grafts, and now antibiotic beads. Dr. Bandyk’s method allows for more rapid closure of the wound, instead of allowing healing by secondary intent, but it does require several trips to the OR for bead exchanges. His outcomes have certainly been excellent, with only 7% of these complex patients developing recurrent infections over a 3-year period and just one to three bead exchanges per patient.

Dr. Linda Harris is vice chair, faculty development, department of surgery, Millard Fillmore Gates Hospital-Kaleida, Buffalo, N.Y.She has no relevant disclosures.



In response to a question as to whether the type of incision was an issue regarding SSI, Dr. Bandyk said: "It’s the patient that’s producing the infection, and certain patient characteristics, so it isn’t necessarily how we’re closing, which way we are putting the incision ... So don’t blame yourself for every surgical site infection. It’s the patient factors that are operative in many of these cases. Of almost all of our infections that occurred, two-thirds came from the MRSA-colonized patient," he said.

Dr. Bandyk reported being on the speakers bureau and having received funding from Cubist Pharmaceuticals, the manufacturer of daptomycin (Cubicin).


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