Publications by authors named "H Lazar"
Despite evidence suggesting the benefit of prophylactic regional antibiotic delivery (RAD) to sternal edges during cardiac surgery, it is seldom performed in clinical practice. The value of topical vancomycin and gentamicin for sternal wound infections (SWI) prophylaxis was further questioned by recent studies including randomized controlled trials (RCTs). The aim of this systematic review and meta-analysis was to comprehensively assess the safety and effectiveness of RAD to reduce the risk of SWI.
View Article and Find Full Text PDFBackground: Surgical ablation for atrial fibrillation at the time of isolated coronary artery bypass grafting is reluctantly attempted. Meanwhile, complete revascularization is not always possible in these patients. We attempted to counterbalance the long-term benefits of surgical ablation against the risks of incomplete revascularization.
View Article and Find Full Text PDFArticle Synopsis
- Routine use of topical vancomycin after cardiac surgery is often overlooked, despite it being recommended in guidelines and questioned in recent trials for its effectiveness against sternal wound infections.
- An analysis of 20 studies, including both randomized controlled trials and observational studies, showed that topical vancomycin reduced the risk of sternal wound infections by nearly 70%, with benefits seen for both superficial and deep infections.
- The treatment's effectiveness was particularly pronounced in patients with diabetes, and no resistance to vancomycin or methicillin was found, leading to a significant decrease in gram-negative cultures as well.