The Use of Local Vancomycin Powder in Degenerative Spine Surgery

Overview

Journal Eur Spine J

Specialty Orthopedics

Date 2015 Aug 8

PMID 26249032

Citations 15

Authors

Josh E Schroeder

Fredrico P Girardi

Harvinder Sandhu

Joseph Weinstein

Frank P Cammisa

Andrew Sama

Affiliations

Soon will be listed here.

Abstract

Purpose: Wound infection after spine surgery is a debilitating complication. Local placement of vancomycin powder into the surgical wounds prior to closing of the fascia has been introduced as a method to reduce deep infection rates.

Methods: The infection rates of all the patients who were treated with intra-operative local vancomycin between June 2012 and June 2013 were compared to all cases that were not treated with vancomycin between January 2009 and December 2010. Patients for both groups were operated by four senior, fellowship-trained spine surgeons with a combined experience of 55 years of practice at a referral orthopedic center. Patients' charts and microbiology reports were reviewed.

Results: 1224 cases were performed with the use of vancomycin. The average age was 56.3 years (SD -13.2; NS). The male to female ratio was 1:1.12 (NS). 2253 cases were performed without the use of vancomycin. The average patient age was 57.1 years (SD 14.5). The male to female ratio was 1:1.14. There were 30 cases of deep infections needing a surgical irrigation and debridement without vancomycin versus 5 when vancomycin was used (P = 0.04). Infections in patients treated with vancomycin were not vancomycin-resistant bacteria.

Conclusion: In conclusion, the use of vancomycin reduces the rate of deep wound infections and irrigation and debridement procedures after spine surgery in a referral center among surgeons with a high surgical volume.

Citing Articles

Effect of powdered vancomycin on stopping surgical site wound infections in neurosurgery: A meta-analysis.

Tian B, He Y, Han Z, Liu T, Zhang X Int Wound J. 2022; 20(4):1139-1150.

PMID: 36237125 PMC: 10031230. DOI: 10.1111/iwj.13973.

Efficacy and safety of intrawound antibiotics in patients undergoing posterior spinal fusion for adolescent idiopathic scoliosis: a nationwide database study.

Shin J, Leggett A, Berg A, Kaushal N, Vives M Spine Deform. 2022; 11(2):313-318.

PMID: 36178631 DOI: 10.1007/s43390-022-00585-7.

A microbiology study on the wounds of pediatric patients undergoing spinal fusion for scoliosis.

Rudolph T, Floccari L, Crawford H, Field A Spine Deform. 2022; 11(2):305-312.

PMID: 36151443 DOI: 10.1007/s43390-022-00590-w.

Effectiveness of topical vancomycin in the prevention of spinal surgical site infections: a retrospective cohort study.

Tafish R, Alkhaldi A, Bourghli A, Althunian T Antimicrob Resist Infect Control. 2021; 10(1):136.

PMID: 34565484 PMC: 8474778. DOI: 10.1186/s13756-021-01006-6.

Efficacy of prophylactic application of vancomycin powder in preventing surgical site infections after instrumented spinal surgery: A retrospective analysis of patients with high-risk conditions.

Oktay K, Ozsoy K, Cetinalp N, Erman T, Guzel A Acta Orthop Traumatol Turc. 2021; 55(1):48-52.

PMID: 33650511 PMC: 7932725. DOI: 10.5152/j.aott.2021.18372.

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