Computed Tomography Imaging Assessment of the Effect of Vancomycin Paste on Poststernotomy Healing

Mohammad Abd Alkhalik Basha,1 Dina Said Shemais,2 Essam Saad Abdelwahed,2 Rabab Mahmoud Elfwakhry,1 Ayman Fathy Zeid,1 Ahmed A El-Hamid M Abdalla,1 Sameh Abdelaziz Aly,3 Dalia Said Abdelrahman,3 Anwar A Elshenawy,4 Waleed Mansour,5 Khaled Ahmed Ahmed Elbanna,6 Mohammad El Tahlawi,7 Nezar Elnahal2 1D...

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Autores principales:	Basha MAA, Shemais DS, Abdelwahed ES, Elfwakhry RM, Zeid AF, Abdalla AAEHM, Aly SA, Abdelrahman DS, Elshenawy AA, Mansour W, Elbanna KAA, El Tahlawi M, Elnahal N
Formato:	article
Lenguaje:	EN
Publicado:	Dove Medical Press 2021
Materias:	computed tomography sternal healing poststernotomy vancomycin paste Medicine (General) R5-920
Acceso en línea:	https://doaj.org/article/abb55dbc7de44121b454089a1bf567aa
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spelling	oai:doaj.org-article:abb55dbc7de44121b454089a1bf567aa2021-12-02T19:17:36ZComputed Tomography Imaging Assessment of the Effect of Vancomycin Paste on Poststernotomy Healing1178-7074https://doaj.org/article/abb55dbc7de44121b454089a1bf567aa2021-12-01T00:00:00Zhttps://www.dovepress.com/computed-tomography-imaging-assessment-of-the-effect-of-vancomycin-pas-peer-reviewed-fulltext-article-IJGMhttps://doaj.org/toc/1178-7074Mohammad Abd Alkhalik Basha,1 Dina Said Shemais,2 Essam Saad Abdelwahed,2 Rabab Mahmoud Elfwakhry,1 Ayman Fathy Zeid,1 Ahmed A El-Hamid M Abdalla,1 Sameh Abdelaziz Aly,3 Dalia Said Abdelrahman,3 Anwar A Elshenawy,4 Waleed Mansour,5 Khaled Ahmed Ahmed Elbanna,6 Mohammad El Tahlawi,7 Nezar Elnahal2 1Department of Radiodiagnosis, Faculty of Human Medicine, Zagazig University, Zagazig, Egypt; 2Department of Cardiothoracic Surgery, Faculty of Human Medicine, Zagazig University, Zagazig, Egypt; 3Department of Radiodiagnosis, Faculty of Human Medicine, Benha University, Benha, Egypt; 4Department of Surgical Oncology, Faculty of Human Medicine, Aswan University, Aswan, Egypt; 5Department of Chest Medicine, Faculty of Human Medicine, Zagazig University, Zagazig, Egypt; 6Department of Internal Medicine, Faculty of Human Medicine, Zagazig University, Zagazig, Egypt; 7Department of Cardiology, Faculty of Human Medicine, Zagazig University, Zagazig, EgyptCorrespondence: Mohammad Abd Alkhalik BashaDepartment of Radiodiagnosis, Faculty of Human Medicine, Zagazig University, Zagazig, 44631, EgyptTel +20 1099098900Email Mohammad_basha76@yahoo.comPurpose: To assess vancomycin paste effect on poststernotomy healing in high-risk coronary artery bypass grafting (CABG) patients compared to bone wax using the 6-point computed tomography (CT) score. Additionally assessed the reliability of this score and its relationship to the occurrence of infection.Patients and Methods: A prospective comparative analysis included 126 high-risk CABG patients. The patients were randomly assigned into bone wax or vancomycin paste for sternal haemostasis. All patients were submitted to CT examinations 6-months postoperative. Two radiologists independently reviewed all CT scans to assess sternal healing using the 6-point CT score. The CT healing score of the two groups was compared. The kappa statistics were used to calculate the inter-reader agreement (IRA) of the 6-point CT score.Results: The final analysis included 61 patients in each group. The main CT score for sternal healing was 3.9± 0.4 in the vancomycin group and 3.3± 0.8 in the bone wax group. Patients in the vancomycin group had a higher statistically significant improvement in CT healing score than those in the bone wax group (p< 0.001). There was no statistically significant relationship (p = 0.79) between the occurrence of infection and the 6-point CT score in the vancomycin group. The overall IRA of the 6-point CT score was good in two groups (κ = 0.79 in the vancomycin group and = 0.78 in the bone wax group).Conclusion: Vancomycin paste had a better CT healing score and can be used as a sternal haemostatic material instead of bone wax. The 6-point CT healing score is a reliable diagnostic tool for evaluating sternal healing.Keywords: computed tomography, sternal healing, poststernotomy, vancomycin paste, CTBasha MAAShemais DSAbdelwahed ESElfwakhry RMZeid AFAbdalla AAEHMAly SAAbdelrahman DSElshenawy AAMansour WElbanna KAAEl Tahlawi MElnahal NDove Medical Pressarticlecomputed tomographysternal healingpoststernotomyvancomycin pasteMedicine (General)R5-920ENInternational Journal of General Medicine, Vol Volume 14, Pp 9287-9296 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	computed tomography sternal healing poststernotomy vancomycin paste Medicine (General) R5-920
spellingShingle	computed tomography sternal healing poststernotomy vancomycin paste Medicine (General) R5-920 Basha MAA Shemais DS Abdelwahed ES Elfwakhry RM Zeid AF Abdalla AAEHM Aly SA Abdelrahman DS Elshenawy AA Mansour W Elbanna KAA El Tahlawi M Elnahal N Computed Tomography Imaging Assessment of the Effect of Vancomycin Paste on Poststernotomy Healing
description	Mohammad Abd Alkhalik Basha,1 Dina Said Shemais,2 Essam Saad Abdelwahed,2 Rabab Mahmoud Elfwakhry,1 Ayman Fathy Zeid,1 Ahmed A El-Hamid M Abdalla,1 Sameh Abdelaziz Aly,3 Dalia Said Abdelrahman,3 Anwar A Elshenawy,4 Waleed Mansour,5 Khaled Ahmed Ahmed Elbanna,6 Mohammad El Tahlawi,7 Nezar Elnahal2 1Department of Radiodiagnosis, Faculty of Human Medicine, Zagazig University, Zagazig, Egypt; 2Department of Cardiothoracic Surgery, Faculty of Human Medicine, Zagazig University, Zagazig, Egypt; 3Department of Radiodiagnosis, Faculty of Human Medicine, Benha University, Benha, Egypt; 4Department of Surgical Oncology, Faculty of Human Medicine, Aswan University, Aswan, Egypt; 5Department of Chest Medicine, Faculty of Human Medicine, Zagazig University, Zagazig, Egypt; 6Department of Internal Medicine, Faculty of Human Medicine, Zagazig University, Zagazig, Egypt; 7Department of Cardiology, Faculty of Human Medicine, Zagazig University, Zagazig, EgyptCorrespondence: Mohammad Abd Alkhalik BashaDepartment of Radiodiagnosis, Faculty of Human Medicine, Zagazig University, Zagazig, 44631, EgyptTel +20 1099098900Email Mohammad_basha76@yahoo.comPurpose: To assess vancomycin paste effect on poststernotomy healing in high-risk coronary artery bypass grafting (CABG) patients compared to bone wax using the 6-point computed tomography (CT) score. Additionally assessed the reliability of this score and its relationship to the occurrence of infection.Patients and Methods: A prospective comparative analysis included 126 high-risk CABG patients. The patients were randomly assigned into bone wax or vancomycin paste for sternal haemostasis. All patients were submitted to CT examinations 6-months postoperative. Two radiologists independently reviewed all CT scans to assess sternal healing using the 6-point CT score. The CT healing score of the two groups was compared. The kappa statistics were used to calculate the inter-reader agreement (IRA) of the 6-point CT score.Results: The final analysis included 61 patients in each group. The main CT score for sternal healing was 3.9± 0.4 in the vancomycin group and 3.3± 0.8 in the bone wax group. Patients in the vancomycin group had a higher statistically significant improvement in CT healing score than those in the bone wax group (p< 0.001). There was no statistically significant relationship (p = 0.79) between the occurrence of infection and the 6-point CT score in the vancomycin group. The overall IRA of the 6-point CT score was good in two groups (κ = 0.79 in the vancomycin group and = 0.78 in the bone wax group).Conclusion: Vancomycin paste had a better CT healing score and can be used as a sternal haemostatic material instead of bone wax. The 6-point CT healing score is a reliable diagnostic tool for evaluating sternal healing.Keywords: computed tomography, sternal healing, poststernotomy, vancomycin paste, CT
format	article
author	Basha MAA Shemais DS Abdelwahed ES Elfwakhry RM Zeid AF Abdalla AAEHM Aly SA Abdelrahman DS Elshenawy AA Mansour W Elbanna KAA El Tahlawi M Elnahal N
author_facet	Basha MAA Shemais DS Abdelwahed ES Elfwakhry RM Zeid AF Abdalla AAEHM Aly SA Abdelrahman DS Elshenawy AA Mansour W Elbanna KAA El Tahlawi M Elnahal N
author_sort	Basha MAA
title	Computed Tomography Imaging Assessment of the Effect of Vancomycin Paste on Poststernotomy Healing
title_short	Computed Tomography Imaging Assessment of the Effect of Vancomycin Paste on Poststernotomy Healing
title_full	Computed Tomography Imaging Assessment of the Effect of Vancomycin Paste on Poststernotomy Healing
title_fullStr	Computed Tomography Imaging Assessment of the Effect of Vancomycin Paste on Poststernotomy Healing
title_full_unstemmed	Computed Tomography Imaging Assessment of the Effect of Vancomycin Paste on Poststernotomy Healing
title_sort	computed tomography imaging assessment of the effect of vancomycin paste on poststernotomy healing
publisher	Dove Medical Press
publishDate	2021
url	https://doaj.org/article/abb55dbc7de44121b454089a1bf567aa
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Computed Tomography Imaging Assessment of the Effect of Vancomycin Paste on Poststernotomy Healing

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