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34 A single-center study, published check details in 2012 by Birgand et al (Table 2), compared the incidence of DSWI requiring surgery in high-risk patients defined as BIMA harvesting plus overweight (BMI > 30 kg/m2) and/or insulin-dependent diabetes.35 The authors did not find any difference regarding the incidence of DSWI between patients receiving a GICS and those who did not receive it (12.6% vs 13.8%, respectively); interestingly, in that series, the probability of DSWI caused by a gentamicin-resistant bacterium was higher in the GICS group (21/27, 77.8%) compared with the other patients (23/56, 41.1%; P Azastene at two months in the treatment group (4.3% vs 9%, RR 0.47; 95% confidence interval [CI] 0.33�C0.68, P Pictilisib order of early resternotomy. The authors repeated their analysis, excluding the patients reoperated for bleeding (or other reasons) and those who died within two months; in this subgroup, there was still a significantly lower incidence of SSWIs (2.5% vs 6.7%, P = 0.001) and DSWIs (2.1 vs 3.3%, P = 0.088) in the GICS group. In 2012, Creanor et al published a meta-analysis including randomized controlled trials, which had previously investigated the use of GICS in cardiac surgery.36 One of the subanalyses of this study was conducted considering high-risk patients; a statistically significant difference between treatment and control group was found with regard to DSWIs (odds ratio [OR] 0.62, 95% CI 0.39�C0.98), while no difference was found with regard to any SWI (OR 0.60, 95% CI 0.24�C1.52).36 In a recent study published in 2014, Benedetto and Raja33 identified the most important risk factors for DSWI after cardiac surgery. In their large analysis involving 8750 cardiac surgical patients, the authors identified several variables that can have an impact on the development of this complication: female gender, obesity, insulin-dependent diabetes, need for re-exploration, isolated or combined CABG, and the use of bilateral mammary artery.33 Using these variables, the authors were able to create a risk score to guide the use of GICS, demonstrating that an individual assessment of DSWI risk is realizable.