Is there a difference between two different skin disinfection methods in cardiac surgery in terms of isolated pathogens?

Introduction: In this study, our aim was to prospectively compare the different methods of patient disinfections with scrubbing + iodine + alcohol, and the povidone iodine disinfection method, which can be described as classical, in terms of the pathogens isolated on skin and during early postoperative complications. Methodology: Eighty patients undergoing a coronary artery bypass operation were included in the study. The patients were divided into two groups: group 1 (n = 48) patients who underwent scrub, iodine, followed by skin disinfection with alcohol, and group 2 (n = 32) who were treated with povidone iodine three times. The samples were immediately sent to the microbiology laboratory. Specimens from the wounds were incubated under aerobic and anaerobic conditions, and isolates were identified using standard microbiological techniques. Results: In samples taken after disinfection in group 1, significantly less reproduction was observed compared to group 2 (p = 0.001). There was no difference in postoperative complications between the two groups except for pleural effusion (p = 0.040). S. epidermidis was the most frequently isolated pathogen in both groups. Conclusion: We did not find a study which compares scrub + alcohol + iodine and povidone iodine in our literature review. We think that our study is original in this respect. We can conclude that skin disinfection with scrub + alcohol + iodine was superior to using only povidone iodine in terms of the pathogens isolated afterwards from the wound.

Robert H. Goetz: A Heritage of Coronary Artery Bypass Surgery

Robert H. Goetz performed the first successful clinical coronary artery bypass operation on May 2, 1960. He used a nonsuture technique to connect the right internal mammary artery to the coronary artery by means of a modified Payr’s cannula made of tantalum. The patency of the anastomosis was demonstrated angiographically and the patient remained free of angina pectoris for 1 year. It was an important and brave step forward, a step that was far ahead of its time. But unfortunately, his pioneering work was not appreciated properly. Bangladesh Heart Journal 2019; 34(2) : 132-136

Atrial fibrillation after Coronary Artery Bypass Surgery with and without Cardiopulmonary Bypass

Background:Atrial fibrillation (AF) is the most common postoperative supraventricular arrhythmi. 20% to 40% of patients have AF after coronary artery bypass operation (CABG).Arrhythmia of all grades may occur due to cardiopulmonary bypass (CPB) and injuries inflicted during operativeprocedures. Thus it has been proposed that CABG surgery would be safer if CPB could be avoided.Methods:Total 60 patients who underwentCABG were selected for the study and divided in two groups. Group A: 30 patients with Off-pump CABG (OPCAB) and Group B: 30 patients with On-pump CABG. 12 lead ECG was done at morning on the day of surgery, after surgery & when any arrhythmia are noted for at least 7days. Morbidity of patients like arrhythmia and hospital mortality were recorded and compared during the first week after surgery.Results:Off-pump group (group- A) had less incidence of post-operative AF than on-pump group(group-B) (10% vs 40%). Postoperative blood requirement,total operative time, the period of mechanical ventilation,ICU stay and total postoperative hospital stayis significantly shorter in off-pump than in on-pump group of patients.Conclusion: This study clearly demonstrates that off pump CABG procedure is associated with less incidence of AF. Therefore OPCAB procedure for myocardial revascularization is clearly justified whenever feasible.Cardiovasc. j. 2018; 10(2): 171-179