This vanguard study will be conducted at two study sites in Canada. It is a cluster randomized trial to test a combination of two antibiotics for antibiotic prophylaxis as compared to routine prophylaxis with one single antibiotic, and to test a negative-pressure wound management system (Prevena) versus standard wound dressing to reduce chest wound infections.
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Adherence to the wound management system
Timeframe: Prevena or standard wound dressing applied after surgery as per protocol, assessed up to 90 days after surgery
Adherence to the antibiotic regimen
Timeframe: Cefazolin: within an hour of surgery; one intra-operative dose at 4 hours after the first dose or upon wound closure (whatever comes first); two post-operative doses q8h. Vancomycin: initially intravenously; second dose 12 hrs after the first dose.
Loss of follow-up
Timeframe: up to 90 days after surgery