There is clinical equipoise around the optimal choice of antibiotics: the addition of vancomycin to routine prophylaxis may further reduce s-SSI rates and is becoming more popular in particular in the United States. However, no guideline or evidence is currently supporting this approach.

Negative pressure wound dressing technology is showing promising results in several small RCTs in different patient populations as recently summarized in a systematic review, but large, convincing and rigorous studies showing a reduction in surgical site infections are needed.

The objective of PICS Prevena, a randomized 2×2 factorial cluster crossover study, is to determine whether adding vancomycin to cefazolin as well as whether negative-pressure dressing technology (Prevena from KCI-Acelity) can reduce deep sternal surgical site infections following cardiac surgery.

PICS-Prevena Slides - Download PDF
Study Type

Interventional - Drug

Study Design

Randomized 2x2 factorial cluster crossover

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NO. of Sites


NO. of Participants


Study Period





Provided the negative pressure wound dressing (Prevena) at no cost. Provided funding for site fees and site coordination.

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