Vancomycin powder for the prevention of surgical site infection in posterior elective spinal surgery

2020 ◽  
Vol 31 (2) ◽  
pp. 64-75
Author(s):  
Pedro David Delgado-López ◽  
Javier Martín-Alonso ◽  
Vicente Martín-Velasco ◽  
José Manuel Castilla-Díez ◽  
Ana Galacho-Harriero ◽  
...  
2014 ◽  
Vol 21 (6) ◽  
pp. 974-983 ◽  
Author(s):  
Nickalus R. Khan ◽  
Clinton J. Thompson ◽  
Michael DeCuypere ◽  
Jonathan M. Angotti ◽  
Erick Kalobwe ◽  
...  

Object Surgical site infection (SSI) is a serious and costly complication of spinal surgery. There have been several conflicting reports on the use of intrawound vancomycin powder in decreasing SSI in spine surgery. The purpose of this study is to answer the question: “Does intrawound vancomycin powder reduce the rate of SSIs in spine surgery?” Methods A comprehensive search of multiple electronic databases and bibliographies was conducted to identify clinical studies that evaluated the rates of SSI with and without the use of intrawound vancomycin powder in spine surgery. Independent reviewers extracted data and graded the quality of each paper that met inclusion criteria. A random effects meta-analysis was then performed. Results The search identified 9 retrospective cohort studies (Level III evidence) and 1 randomized controlled trial (Level II evidence). There were 2574 cases and 106 infections in the control group (4.1%) and 2518 cases and 33 infections (1.3%) in the treatment group, yielding a pooled absolute risk reduction and relative risk reduction of 2.8% and 68%, respectively. The meta-analysis revealed the use of vancomycin powder to be protective in preventing SSI (relative risk = 0.34, 95% confidence interval 0.17–0.66, p = 0.021). The number needed to treat to prevent 1 SSI was 36. A subgroup analysis found that patients who had implants had a reduced risk of SSI with vancomycin powder (p = 0.023), compared with those who had noninstrumented spinal operations (p = 0.226). Conclusions This meta-analysis suggests that the use of vancomycin powder may be protective against SSI in open spinal surgery; however, the exact population in which it should be used is not clear. This benefit may be most appreciated in higher-risk populations or in facilities with a high baseline rate of infection.


2018 ◽  
Vol 18 (12) ◽  
pp. 2205-2212 ◽  
Author(s):  
Chiaki Horii ◽  
Takashi Yamazaki ◽  
Hiroyuki Oka ◽  
Seiichi Azuma ◽  
Satoshi Ogihara ◽  
...  

Spine ◽  
2015 ◽  
Vol 40 (7) ◽  
pp. 491-499 ◽  
Author(s):  
Marko Tomov ◽  
Lance Mitsunaga ◽  
Blythe Durbin-Johnson ◽  
Deepak Nallur ◽  
Rolando Roberto

2017 ◽  
Vol 3 (3) ◽  
pp. 89-94
Author(s):  
Homayoun Tabesh ◽  
Mohammad Kamangar ◽  
Aryan Tabesh ◽  
Amin Rastgoo ◽  
Ehsan Mohammadhosseini ◽  
...  

BMC Surgery ◽  
2018 ◽  
Vol 18 (1) ◽  
Author(s):  
Dong Yin ◽  
Bin Liu ◽  
Yunbing Chang ◽  
Honglin Gu ◽  
Xiaoqing Zheng

Neurosurgery ◽  
2018 ◽  
Vol 85 (6) ◽  
pp. 817-826 ◽  
Author(s):  
Andrew K Chan ◽  
Simon G Ammanuel ◽  
Alvin Y Chan ◽  
Taemin Oh ◽  
Henry C Skrehot ◽  
...  

Abstract BACKGROUND Surgical site infection (SSI) is a common complication following spinal surgery. Prevention is critical to maintaining safe patient care and reducing additional costs associated with treatment. OBJECTIVE To determine the efficacy of preoperative chlorhexidine (CHG) showers on SSI rates following fusion and nonfusion spine surgery. METHODS A mandatory preoperative CHG shower protocol was implemented at our institution in November 2013. A cohort comparison of 4266 consecutive patients assessed differences in SSI rates for the pre- and postimplementation periods. Subgroup analysis was performed on the type of spinal surgery (eg, fusion vs nonfusion). Data represent all spine surgeries performed between April 2012 and April 2016. RESULTS The overall mean SSI rate was 0.4%. There was no significant difference between the pre- (0.7%) and postimplementation periods (0.2%; P = .08). Subgroup analysis stratified by procedure type showed that the SSI rate for the nonfusion patients was significantly lower in the post- (0.1%) than the preimplementation group (0.7%; P = .02). There was no significant difference between SSI rates for the pre- (0.8%) and postimplementation groups (0.3%) for the fusion cohort (P = .21). In multivariate analysis, the implementation of preoperative CHG showers were associated with significantly decreased odds of SSI (odds ratio = 0.15, 95% confidence interval [0.03-0.55], P < .01). CONCLUSION This is the largest study investigating the efficacy of preoperative CHG showers on SSI following spinal surgery. In adjusted multivariate analysis, CHG showering was associated with a significant decrease in SSI following spinal surgery.


2018 ◽  
Vol Volume 14 ◽  
pp. 2149-2159 ◽  
Author(s):  
Abuduwufuer Tailaiti ◽  
Jun Shang ◽  
Shuo Shan ◽  
Aikeremujiang Muheremu

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