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
| Autor: | Kerem Mazhar Özsoy, Tahsin Erman, Aslan Guzel, Kadir Oktay, Nuri Eralp Cetinalp |
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| Rok vydání: | 2021 |
| Předmět: |
Male
medicine.medical_specialty Subgroup analysis Treatment and control groups lcsh:Orthopedic surgery Risk Factors Vancomycin Surgical site Retrospective analysis Humans Surgical Wound Infection Medicine Orthopedic Procedures Orthopedics and Sports Medicine In patient Retrospective Studies business.industry General Medicine Antibiotic Prophylaxis Middle Aged Spine Spinal surgery Anti-Bacterial Agents Surgery lcsh:RD701-811 Regimen Female Risk Adjustment Powders business Research Article medicine.drug |
| Zdroj: | Acta Orthopaedica et Traumatologica Turcica, Vol 55, Iss 1, Pp 48-52 (2021) Acta Orthop Traumatol Turc |
| ISSN: | 2589-1294 1017-995X |
| Popis: | Objective This study aimed to determine the efficacy of prophylactic use of vancomycin powder against surgical site infections in patients with high-risk conditions who underwent posterior spinal instrumentation. Methods Data obtained from 209 patients who underwent posterior spinal instrumentation at a single institution from 2014 to 2017 were retrospectively reviewed. Patients were then divided into two groups: control group, including 107 patients (61 females, 46 males; mean age=54 years; age range=16-85 years), and treatment group, including 102 patients (63 females, 39 males; mean age=53 years; age range=14-90 years). All patients received the same standard prophylactic antibiotic regimen. In addition to the prophylactic antibiotic, vancomycin powder was applied locally to the surgical site in the treatment group. All patients were followed up for at least 90 days postoperatively. Infections were categorized as superficial and deep infections. Subgroup analysis of high-risk patients (Syrian refugees) was also performed. Results The infection rates were 1.96% (two patients) in the treatment group and 6.54% (seven patients) in the control group. A significant decrease in the infection rates was observed with local vancomycin powder application. Advanced age (>46 years) and prolonged surgical duration (>140 min) were found to be the main risk factors for surgical site infections (p=0.004 and p=0.028, respectively). The infection rates were 3.22% and 8.11% in the treatment and control groups of refugees, respectively. There were three superficial and four deep infections in the control group and one superficial and one deep infection in the treatment group. A dominance of staphylococcus infections was observed in the control group, whereas no significant dominance was observed in the treatment group. Three patients in the control group and one patient in the treatment group received implant removal. Conclusion Evidence from this study has revealed that local application of vancomycin powder reduces the rate of surgical site infections after instrumented spinal surgery. The benefit of vancomycin application may be most appreciated in higher risk populations or in clinics with high baseline rates of infection. Level of evidence Level III, Therapeutic Study. |
| Databáze: | OpenAIRE |
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