Has any one else tried mixing betadine ointment 50/50 with bone wax before using the mixture on the cut sternum to reduce the risk of infection? We started this at Dameron Hospital in 1990 but we never published the results. It was my distinct impression that it significantly reduced post-op sternal infections.
The other problem I have seen is micro tears jn rubber gloves after applying bone wax to the cut bone. The way to avoid this is to use a wooden spatula.
I would be interested in any comments.
Sincerely,
Alan Coulson
Several interventions can decrease sternal infections/seromas. The primary step is to make sure stabilization is maximal. any motion of the sternum promotes seromas that can lead to infections and wound/sternal dehiscence. The STATE of the ART!!! is via plate s. The KLS Martin TALON, or synthes plating techniques are the two most documented and dependable.The second intervention could be to use a "pain Pump" to infuse a mixed antibiotic/anesthetic mixture directly over the repaired sternum. This infusion lasts approximately three days, lessens post-op pain and delivers antibiotics directly to the wounded area. Finally, pectoralis muscle flaps overlying the repaired sternum can be the way to maximize oxygen, lymphokine,cytokine release into the surgical site. These interventions are proven, and documented. Finally, CO2 laser treatment of the surgical exposed wound can diminish the bacterial population .
A good summary by Dr Arch Miller regarding the evidence base. Thank you.
In terms of reducing medical costs, Dr Alan Coulson's suggestion regarding betadine-povidone ointment would be well worth pursuing with a clinical study. Perhaps revisit the data at the Dameron Hospital in 1990.
This is despite the controversial opinions regarding toxicity of betadine in vitro in various studies.
The results in vivo might be quite different, especially at lower concentrations.
Thank you for the input!
I will try and retrieve data from 1990; it will not be an easy task.
Even if we can just prevent one sternal infection, it will all be worthwhile.
Sincerely
Alan Coulson
Your idea of using betadine is excellent . I will try in our hospital and observe the result. All the comments are appreciated. I want to add another point that after surgery the mediasterninal cavity and the sternal edge should thoroughly washed with normal saline . Bcz the residual clot or blood products are source of infection and activate the inflammatory cascade.
definitely, it is an innovative idea to utililize betadine ointment and bone wax mixture to reduce the risk of wound infection. As iodide containing substancs are definitely beneficial and such should be promoted.
- Badges
- Science topic
- Similar topics
- Biological Science
- Anatomy
- Tissue