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Impact of Polyhexanide Care Bundle on Surgical Site Infections in Paediatric and Neonatal Cardiac Surgery: A

Gianluca Castiello1, Giuseppe Caravella2, Greta Ghizzardi3

  • 1Intensive Care Unit, IRCCS Policlinico San Donato, Milan, Italy.

International Wound Journal
|June 12, 2025
PubMed

Insights

The polyhexamethylene biguanide (PHMB) care bundle significantly reduced surgical site infections (SSIs) in paediatric cardiac surgery. This infection prevention protocol offers a promising strategy for improving patient outcomes in this vulnerable population.

Area of Science:

  • Medical Research
  • Infectious Disease Prevention
  • Paediatric Surgery

Background:

  • Surgical site infections (SSIs) pose a significant risk in paediatric and neonatal cardiac surgery.
  • Existing infection prevention protocols often lack paediatric-specific considerations.
  • There is a critical need for effective strategies to reduce SSIs in this patient group.

Purpose of the Study:

  • To evaluate the impact of a polyhexamethylene biguanide (PHMB) care bundle on SSI rates.
  • To assess the efficacy of this intervention in paediatric and neonatal cardiac surgery patients.
  • To address the gap in paediatric-specific infection prevention.

Main Methods:

  • Retrospective cohort study comparing PHMB care bundle (Cohort A) with conventional care (Cohort B).
  • Included patients under 18 years undergoing cardiac surgery.
  • Propensity score matching (1:1) was used to create comparable cohorts (n=114 each).

Main Results:

  • A significant reduction in SSIs was observed in the PHMB care bundle group (1.8%) compared to the conventional care group (7.1%, p=0.048).
  • The PHMB care bundle included educational programs, antimicrobial treatments, and best practice implementation.
  • The intervention demonstrated a marked decrease in infection rates.

Conclusions:

  • The PHMB care bundle is effective in reducing SSIs in paediatric cardiac surgery.
  • Antimicrobial care bundles represent a promising approach for SSI prevention in this population.
  • Further prospective research is recommended to refine the PHMB bundle.

Keywords:
cardiac surgeryinfection controlpaediatric surgerypolyhexanidesurgical site infection

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