[HSF] Re: Post op antibiotics

[Ani Anyanwu]

Dr Harris
 
Amazing series - I suspect more though that your surgical technique and infection control practices may contribute more to the rarity of mediastinitis than the antibiotics and CRP. What protocol did you use before the last 700 cases and what was your infection rate then? Do you have trainee surgeons? 
 
Thanks
 
Ani



> Date: Sat, 22 Sep 2007 22:16:23 +0100> From: drdharris at yahoo.co.uk> Subject: RE: [HSF] Re: Post op antibiotics> To: OpenHeart-L at lists.hsforum.com> CC: > > For CABG patients 24 hrs.> > For valves, until lines and drains out.> > Then track the CRP levels every second day to make> sure the trend is downward, and there is no peak just> before discharge. This way you can avoid> mediastinitis, as you can treat it as it starts.> Since doing this have not had a single case of sternal> sepsis in the last 700 patients, but have had CRP> peaks which we then confirm the next day, then treat.> Some developed cellulitis a few days afterwards, while> on treatment, but we were able to avoid debridements.> > Dave Harris> > > --- Adam Saltman <aes.md.phd at hotmail.com> wrote:> > > It is actually policy at our institution now to> > discontinue all prophylactic antibiotics according> > to a time schedule. For general surgery patients> > this is after 24 hours, and for cardiac patients it> > is 48 hours (which actually has no data behind it,> > just some hysterical cardiac surgeons). This is now> > becoming a nation-wide initiative in the prevention> > of infection by drug-resistant organisms... But as> > far as I know, there is no data to support or refute> > any particular strategy in cardiac patients...> > > > Adam> > > > > > > > > From: alsadd at ksu.edu.sa> > > To: OpenHeart-L at lists.hsforum.com> > > Date: Wed, 19 Sep 2007 14:58:29 -0700> > > CC: > > > Subject: [HSF] Re: Post op antibiotics > > > > > > Dear Forum Members:> > > > > > > > > > > > Do the honorable members keep the open heart> > patients on antibiotics for as> > > long as they have mediastinal and chest tubes in> > place? I do not, but some> > > of my colleagues do. I went over the STS> > guidelines the two parts and I> > > could not find the answer to this question.> > > > > > Your response is greatly appreciated.> > > > > > Thank you> > > > > > > > > > > > Ahmed> > > > > > _______________________________________________> > > OpenHeart-L mailing list> > > > > > Send postings to:> > > OpenHeart-L at lists.hsforum.com> > > > > > To UNSUBSCRIBE, to CHANGE email address, or to> > view archives:> > > http://mmp.cjp.com/mailman/listinfo/openheart-l> > > > > > All messages transmitted by the OpenHeart-L are> > subject to the policies and > > > disclaimers posted at:> > > http://www.hsforum.com/listdisclaim> > > -----------------------------------------> > > >> _________________________________________________________________> > Gear up for Halo® 3 with free downloads and an> > exclusive offer. It’s our way of saying thanks for> > using Windows Live™.> >> http://gethalo3gear.com?ocid=SeptemberWLHalo3_WLHMTxt_2_______________________________________________> > OpenHeart-L mailing list> > > > Send postings to:> > OpenHeart-L at lists.hsforum.com> > > > To UNSUBSCRIBE, to CHANGE email address, or to view> > archives:> > http://mmp.cjp.com/mailman/listinfo/openheart-l> > > > All messages transmitted by the OpenHeart-L are> > subject to the policies and> > disclaimers posted at:> > http://www.hsforum.com/listdisclaim> > -----------------------------------------> > > > > Dr. David G. Harris, FCS, MMED,> Cardiothoracic Surgeon > Suite 207 > Kuils River Private Hospital, > PO Box 1200, Kuils River, 7579, Cape Town, South Africa. > Tel +27-21-9006411 > Fax +27-21-9006412 Mobile +27-83-3309587> > _______________________________________________> OpenHeart-L mailing list> > Send postings to:> OpenHeart-L at lists.hsforum.com> > To UNSUBSCRIBE, to CHANGE email address, or to view archives:> http://mmp.cjp.com/mailman/listinfo/openheart-l> > All messages transmitted by the OpenHeart-L are subject to the policies and > disclaimers posted at:> http://www.hsforum.com/listdisclaim> -----------------------------------------
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