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March 14, 2007

Chlorhexidine Gluconate for Prevention of Nosocomial Infection in Cardiac Surgery—Reply

Author Affiliations

Letters Section Editor: Robert M. Golub, MD, Senior Editor.

JAMA. 2007;297(10):1059-1060. doi:10.1001/jama.297.10.1060

In Reply: Dr Scheckler described the rate of deep surgical site infection (SSI) in our study as high, comparing it with an incidence of poststernotomy mediastinitis in the United States of less than 1%. However, we reported the incidence of deep SSIs, comprising a group of SSIs greater than poststernotomy mediastinitis alone. In the United States, the comparable incidence is likely to be higher as well. An incidence of 0.4% to 5.0% for poststernotomy mediastinitis has been reported in other studies.1,2 In our study, the overall incidence of poststernotomy mediastinitis was 1.6% (0.8% in the chlorhexidine group and 2.3% in the placebo group). Therefore, we believe that our preventive strategy can also improve the outcomes in the United States.

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