Intrasite vancomycin powder for the prevention of surgical site infection in spine surgery: a systematic literature review
Autor: | Ronald A. Lehman, Scott C. Wagner, Daniel G. Kang, Terrence F. Holekamp |
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Rok vydání: | 2015 |
Předmět: |
medicine.medical_specialty
business.industry Context (language use) Surgical wound Antibiotic Prophylaxis Spine Anti-Bacterial Agents Spinal Fusion Systematic review Spine surgery Vancomycin Humans Surgical Wound Infection Medicine Surgery Orthopedics and Sports Medicine Neurology (clinical) Significant risk Antibiotic prophylaxis business Intensive care medicine Surgical site infection medicine.drug |
Zdroj: | The Spine Journal. 15:762-770 |
ISSN: | 1529-9430 |
DOI: | 10.1016/j.spinee.2015.01.030 |
Popis: | Background context Deep surgical site infections (SSIs) following spinal surgery are a significant burden to the patient, patient's family, and the health-care system. Because of increasing pressures to reduce SSIs and control costs, some spine surgeons have begun placing lyophilized vancomycin powder directly into the surgical wound at the conclusion of the procedure. However, the literature supporting this practice remains limited. Purpose To review the current literature examining the use of prophylactic intrasite vancomycin powder to control SSIs in spinal surgery and determine if any standard recommendations can be made. Study design A systematic review. Methods Ovid Medline and PubMed were searched to identify English language articles. Results No current guidelines are available for the use of intrasite vancomycin powder in preventing SSIs, and no standard dosage for the drug exists. Based on the limited literature and evidence currently available, there appears to be a protective effect of intrasite vancomycin powder on the incidence of SSI, without evidence of side effects. However, case reports do exist describing the systemic side effects after intrasite vancomycin powder during spine surgery. Conclusions The interpretation of the available evidence supporting the use of intrasite vancomycin powder in surgical wounds is limited, and its extrapolation should be performed with caution. Despite the lack of significant high-quality evidence available in the literature, many surgeons have adopted this practice; anecdotally, it continues to provide protection from infection without apparent significant risk of side effects. |
Databáze: | OpenAIRE |
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