{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,5]],"date-time":"2026-03-05T15:48:36Z","timestamp":1772725716486,"version":"3.50.1"},"reference-count":41,"publisher":"MDPI AG","issue":"3","license":[{"start":{"date-parts":[[2026,3,4]],"date-time":"2026-03-04T00:00:00Z","timestamp":1772582400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Diseases"],"abstract":"<jats:p>The development of sternal infection in neonates after cardiac defect correction using median sternotomy is a serious complication, increasing the length of hospital stay, mortality, and treatment costs. One effective method for preventing this complication is the local administration of antibiotics to the wound. The objective of this study was to evaluate the effect of local antibiotic application on renal and hepatic function in the postoperative period. Methods: A retrospective analysis of the treatment of 130 newborns with congenital heart defects (CHDs) was conducted. A local antibiotic (vancomycin, 0.5\u20131 g) was administered to the wound during sternotomy closure to prevent sternal infection. Liver and kidney function were assessed based on changes in serum alanine aminotransferase (ALT), aspartate aminotransferase (AST), and creatinine levels preoperatively and at 1 and 3 days postoperatively. Data were analyzed using repeated-measures analysis of variance (ANOVA) and Friedman\u2019s chi-square test. Results: In total, local vancomycin was administered to the wound during sternotomy closure in 130 newborns after the correction of CHDs. Thirty-three patients were excluded from the study because intraoperative signs of acute kidney injury were noted. Thus, 97 newborns were included in the study and there were no cases of sternal infection in this cohort of patients. According to the results from the statistical data analysis, the preoperative ALT level was lower (Md = 19.2) than the postoperative ALT level on the first day (Md = 23, p = 0.076). On the third day of postoperative observation, after the local application of vancomycin, the ALT level increased slightly, but remained within the normal range (Md = 26, p &lt; 0.001). The AST level on the first day was higher (Md = 43.2) than the preoperative AST level (Md = 39, p = 0.002). However, on the third day after surgery, the AST level decreased (Md = 36.4, p = 0.059) and remained within the normal range. The differences in the dynamics of ALT levels on the third day and AST on the first day after surgery were statistically significant. These levels corresponded to normal levels, leading to the conclusion that the local application of vancomycin has no effect on the levels of AST and ALT. On the first day after surgery, creatinine values were lower (M = 58.3) than before (M = 62.3, p = 0.073). On the third day of postoperative observation, the creatinine values were lower than before surgery (M = 56.8, p = 0.009). Creatinine levels decreased after the local application of vancomycin. Conclusions: The use of vancomycin locally in the wound intraoperatively in newborns after CHD repair did not result in a clinically significant increase in ALT, AST, or creatinine in the blood plasma in the early postoperative period, proving that there were no negative effects on renal and hepatic function during three postoperative days.<\/jats:p>","DOI":"10.3390\/diseases14030093","type":"journal-article","created":{"date-parts":[[2026,3,5]],"date-time":"2026-03-05T14:19:21Z","timestamp":1772720361000},"page":"93","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Effect of Local Administration of Vancomycin to the Wound on Renal and Hepatic Function After Cardiac Surgery in Neonates"],"prefix":"10.3390","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4683-1454","authenticated-orcid":false,"given":"Vitaliy V.","family":"Suvorov","sequence":"first","affiliation":[{"name":"Department of Surgical Diseases of Children, Saint-Petersburg State Pediatric Medical University, 194100 Saint-Petersburg, Russia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Davlet B.","family":"Sayitkuliev","sequence":"additional","affiliation":[{"name":"Department of Surgical Diseases of Children, Saint-Petersburg State Pediatric Medical University, 194100 Saint-Petersburg, Russia"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2026,3,4]]},"reference":[{"key":"ref_1","first-page":"79","article-title":"Predictors of early-onset neonatal infections (review)","volume":"14","author":"Aleksandrovich","year":"2023","journal-title":"Pediatrician"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"785","DOI":"10.1111\/chd.12779","article-title":"Health care-associated infections are associated with increased length of stay and cost but not mortality in children undergoing cardiac surgery","volume":"14","author":"Tweddell","year":"2019","journal-title":"Congenit. Heart Dis."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"e29991","DOI":"10.1016\/j.heliyon.2024.e29991","article-title":"Efficiency of an algorithm for the prevention of sternal infection after cardiac surgery in children under 1 year of age: A single-center retrospective study","volume":"10","author":"Suvorov","year":"2024","journal-title":"Heliyon"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"963","DOI":"10.1016\/j.ajic.2012.01.012","article-title":"Epidemiology and outcome of major postoperative infections following cardiac surgery: Risk factors and impact of pathogen type","volume":"40","author":"Chen","year":"2012","journal-title":"Am. J. Infect. Control"},{"key":"ref_5","first-page":"368","article-title":"Significant reduction of sternal wound infection in cardiac surgical patients","volume":"20","author":"Vogt","year":"2019","journal-title":"Bull. Bakoulev. Center Cardiovasc. Dis."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"119","DOI":"10.1053\/j.semvascsurg.2008.05.008","article-title":"Vascular surgical site infection: Risk factors and preventive measures","volume":"3","author":"Brandyk","year":"2008","journal-title":"Semin. Vasc. Surg."},{"key":"ref_7","first-page":"89","article-title":"Choise of local antibacterial medications for prevention of sternal infection","volume":"8","author":"Shihverdiev","year":"2017","journal-title":"Pediatrician"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"1907","DOI":"10.2106\/JBJS.G.01237","article-title":"Better prophylaxis against surgical site infection with local as well as systemic antibiotics. An in vivo study","volume":"91","author":"Cavanaugh","year":"2009","journal-title":"J. Bone Jt. Surg. Am."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"618","DOI":"10.1016\/S0022-5223(19)34366-1","article-title":"Reduction of sternal infection by application of topical vancomycin","volume":"98","author":"Okike","year":"1989","journal-title":"J. Thorac. Cardiovasc. Surg."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"59S","DOI":"10.1097\/01.prs.0000225438.86758.21","article-title":"Using physiology to improve surgical wound outcomes","volume":"117","author":"Ueno","year":"2006","journal-title":"Plast. Reconstr. Surg."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"554","DOI":"10.2215\/CJN.01900214","article-title":"AKI in hospitalized children: Comparing the pRIFLE, AKIN, and KDIGO definitions","volume":"10","author":"Sutherland","year":"2015","journal-title":"Clin. J. Am. Soc. Nephrol."},{"key":"ref_12","doi-asserted-by":"crossref","unstructured":"Pacifici, G.M. (2020). Clinical pharmacology of cefuroxime and cefuroxime axetil in infants and children. Clin. Med. Investig., 5.","DOI":"10.15761\/CMI.1000212"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"462","DOI":"10.1177\/02184923241297219","article-title":"Prophylactic 24 versus 48 h cephalosporins in cardiac surgery: A randomized trial","volume":"32","author":"Koudieh","year":"2024","journal-title":"Asian Cardiovasc. Thorac. Ann."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"1012","DOI":"10.1111\/apt.70284","article-title":"Clinical and Genetic Associations in Cephalosporin-Induced Liver Injury: Insights from the Drug-Induced Liver Injury Network","volume":"62","author":"Vuppalanchi","year":"2025","journal-title":"Aliment. Pharmacol. Ther."},{"key":"ref_15","doi-asserted-by":"crossref","unstructured":"Suvorov, V.V., and Ivanov, D.O. (2024). Risk Factors for Surgical Site Infection After Cardiac Surgery in Neonates: A Case\u2013Control Study. J. Clin. Med., 13.","DOI":"10.3390\/jcm13247755"},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"69","DOI":"10.21688\/1681-3472-2017-1-69-72","article-title":"Intraoperative local administration of antibiotics for prevention of sternal wound infection in cardiac surgery","volume":"21","author":"Shikhverdiev","year":"2017","journal-title":"Patol. Krovoobrashcheniya I Kardiokhirurgiya=Circ. Pathol. Card. Surg."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"c179","DOI":"10.1159\/000339789","article-title":"KDIGO clinical practice guidelines for acute kidney injury","volume":"120","author":"Khwaja","year":"2012","journal-title":"Nephron. Clin Pract."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"R31","DOI":"10.1186\/cc5713","article-title":"Acute Kidney Injury Network. Acute Kidney Injury Network: Report of an initiative to improve outcomes in acute kidney injury","volume":"11","author":"Mehta","year":"2007","journal-title":"Crit Care"},{"key":"ref_19","first-page":"50","article-title":"Experimental studies in medicine and public health: Planning, data analysis, interpretation of results","volume":"23","author":"Kholmatova","year":"2016","journal-title":"Ekol. Cheloveka Hum. Ecol."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"216","DOI":"10.1097\/ASW.0000000000000094","article-title":"Effect of Different Local Antibiotic Regimens on Prevention of Postoperative Infection in Clean Surgical Wounds: A Systematic Review and Network Meta-analysis","volume":"37","author":"Pan","year":"2024","journal-title":"Adv. Skin. Wound Care"},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"261","DOI":"10.1177\/01945998221100801","article-title":"Infection control with topical antimicrobial prophylaxis for mucosal head and neck surgery: A meta-analysis","volume":"168","author":"Lee","year":"2023","journal-title":"Otolaryngol. Head Neck Surg."},{"key":"ref_22","doi-asserted-by":"crossref","unstructured":"Flores, M.J., Brown, K.E., Morshed, S., and Shearer, D.W. (2022). Evidence for Local Antibiotics in the Prevention of Infection in Orthopaedic Trauma. J. Clin. Med., 11.","DOI":"10.3390\/jcm11247461"},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"1123","DOI":"10.1002\/bjs.10588","article-title":"Meta-analysis of randomized and quasi-randomized clinical trials of topical antibiotics after primary closure for the prevention of surgical-site infection","volume":"104","author":"Heal","year":"2017","journal-title":"Br. J. Surg."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"656","DOI":"10.3171\/2020.8.SPINE20992","article-title":"Impact of intrawound vancomycin powder on prevention of surgical site infection after posterior spinal surgery","volume":"34","author":"Ushirozako","year":"2021","journal-title":"J. Neurosurg. Spine"},{"key":"ref_25","first-page":"e1023\u20136","article-title":"Can gentamicin-collagen sponges prevent seroma formation following mastectomy?","volume":"18","author":"Polat","year":"2018","journal-title":"Clin. Breast Cancer"},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"1683","DOI":"10.1097\/BRS.0000000000000465","article-title":"Safety of topical vancomycin for pediatric spinal deformity: Nontoxic serum levels with supratherapeutic drain levels","volume":"39","author":"Armaghani","year":"2014","journal-title":"Spine (Phila. Pa 1976)"},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"687","DOI":"10.1093\/toxres\/tfab048","article-title":"Changes of renal transporters in the kinetic process of VCM-induced nephrotoxicity in mice","volume":"10","author":"Li","year":"2021","journal-title":"Toxicol. Res."},{"key":"ref_28","doi-asserted-by":"crossref","unstructured":"Kan, W.C., Chen, Y.C., Wu, V.C., and Shiao, C.C. (2022). Vancomycin-Associated Acute Kidney Injury: A Narrative Review from Pathophysiology to Clinical Application. Int. J. Mol. Sci., 23.","DOI":"10.3390\/ijms23042052"},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"454","DOI":"10.1111\/chd.12746","article-title":"Creatinine-based estimation of glomerular filtration rate in patients with a Fontan circulation","volume":"14","author":"Wilson","year":"2019","journal-title":"Congenit. Heart Dis."},{"key":"ref_30","doi-asserted-by":"crossref","unstructured":"Condit, P.E., Gorski, D.P., Lasarev, M.R., Al-Subu, A.M., and Harer, M.W. (2024). Decreased Intraoperative Renal Tissue Oxygenation after Cardiopulmonary Bypass Predicts Cardiac Surgery-Associated Acute Kidney Injury in Neonates. Children, 11.","DOI":"10.3390\/children11030315"},{"key":"ref_31","doi-asserted-by":"crossref","unstructured":"Wells, Z., Zhu, M., and Young, S.W. (2022). Intraosseous Regional Administration of Prophylactic Antibiotics in Total Knee Arthroplasty. Antibiotics, 11.","DOI":"10.3390\/antibiotics11050634"},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"810","DOI":"10.1089\/sur.2020.303","article-title":"Evaluation of intra-operative topical vancomycin and the incidence of acute kidney injury","volume":"22","author":"Blackman","year":"2021","journal-title":"Surg. Infect."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"118382","DOI":"10.1016\/j.lfs.2020.118382","article-title":"Zingerone attenuates vancomycin-induced hepatotoxicity in rats through regulation of oxidative stress, inflammation and apoptosis","volume":"259","author":"Kucukler","year":"2020","journal-title":"Life Sci."},{"key":"ref_34","doi-asserted-by":"crossref","unstructured":"Tsantes, A.G., Papadopoulos, D.V., Goumenos, S., Ioannou, P., Stavropoulos, N., Petrou, E., Trikoupis, I.G., Koutserimpas, C., Mpakosi, A., and Kontogeorgakos, V.A. (2025). Local Vancomycin Application Reduces Periprosthetic Joint Infections in Oncologic Megaprosthetic Reconstruction: A Retrospective Cohort Study. Antibiotics, 14.","DOI":"10.3390\/antibiotics14090952"},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"66","DOI":"10.1007\/s11999.0000000000000013","article-title":"The John N. Insall Award: Higher Tissue Concentrations of Vancomycin Achieved With Intraosseous Regional Prophylaxis in Revision TKA: A Randomized Controlled Trial","volume":"476","author":"Young","year":"2018","journal-title":"Clin. Orthop. Relat. Res."},{"key":"ref_36","first-page":"60","article-title":"Analysis of systemic serum vancomycin levels following intraarticular application in primary total joint arthroplasty","volume":"145","author":"Stauss","year":"2025","journal-title":"Arch. Orthop. Trauma Surg."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"765","DOI":"10.1016\/S1010-7940(03)00033-2","article-title":"Topical vancomycin applied on closure of the sternotomy wound does not prevent high levels of systemic vancomycin","volume":"23","author":"Desmond","year":"2003","journal-title":"Eur. J. Cardiothorac. Surg."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"452","DOI":"10.1093\/icvts\/ivaa292","article-title":"Does routine topical antimicrobial administration prevent sternal wound infection after cardiac surgery?","volume":"32","author":"Magro","year":"2021","journal-title":"Interact. CardioVasc. Thorac. Surg."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"135","DOI":"10.1016\/j.clinthera.2024.11.024","article-title":"Topical Vancomycin Paste Over the Sternal Edge During Cardiac Surgery: Effects of Renal Function and Body Size on Systemic Exposure","volume":"47","author":"Tsai","year":"2025","journal-title":"Clin. Ther."},{"key":"ref_40","doi-asserted-by":"crossref","unstructured":"O\u2019Dell Duplechin, M., Folds, G.T., Duplechin, D.P., Ahmadzadeh, S., Myers, S.H., Shekoohi, S., and Kaye, A.D. (2025). Prevention and Management of Perioperative Acute Kidney Injury: A Narrative Review. Diseases, 13.","DOI":"10.3390\/diseases13090295"},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"267","DOI":"10.1186\/s13256-024-04574-4","article-title":"Case analysis of hepatotoxicity caused by vancomycin","volume":"18","author":"Wu","year":"2024","journal-title":"J. Med. Case Rep."}],"container-title":["Diseases"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2079-9721\/14\/3\/93\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,3,5]],"date-time":"2026-03-05T14:51:02Z","timestamp":1772722262000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2079-9721\/14\/3\/93"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,3,4]]},"references-count":41,"journal-issue":{"issue":"3","published-online":{"date-parts":[[2026,3]]}},"alternative-id":["diseases14030093"],"URL":"https:\/\/doi.org\/10.3390\/diseases14030093","relation":{},"ISSN":["2079-9721"],"issn-type":[{"value":"2079-9721","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,3,4]]}}}