The Combination of Platelet-Rich Fibrin and Local Antibiotics Optimizes Wound Healing after Deep Sternal Wound Problems and Prevent Reinfection

Objectives: Deep sternal wound healing problems after cardiac surgery are rare but represent a significant problem for the patients. The therapy is highly expensive and consumes personnel resources. A major problem of these patients is infection and reinfection after secondary wound closure. We asked how to prevent an early reinfection with growth factors in combination with local antibiotics.

Methods: A total of 224 patients with a sternal wound healing problem were involved in our study of two groups. After initial vacuum-therapy we planned the secondary wound closure. In group 1 (108 patients), we only used Platelet Rich Fibrin (PRF) during wound closure. In group 2 (116 patients), we covered the wounds intraoperatively with a combination of PRF and local antibiotics (PRF CoDelivery). All patients were observed over 30 days regarding early chirurgical site infection.

Result: A total of 21 patients (19.4%) from group 1 showed a persistent wound healing problem with or without reinfection after 30 days. In group 2, only 12 patients (10.3%) had this problem (p = 0.04 group 1 vs. group 2). The use of PRF and PRF CoDelivery was easy and free of complications. The majority of the patients showed an accelerated wound healing process.

Conclusion: In our study, we see a significant reduction of persistent wound problems using the combination of growth factors and local antibiotics. It can be speculated, that the combination influenced the wound healing process positively and reduced early reinfection. The combination of PRF and local antibiotics is easy to use and demonstrated good results. We did not see any complications. Further studies are necessary to verify these initial findings.

Publication History

Article published online:
19 February 2021