Intrawound Vancomycin Powder Reduces Surgical Site Infections in Posterior Cervical Fusion

Spine ◽  
2013 ◽  
Vol 38 (14) ◽  
pp. 1183-1187 ◽  
Author(s):  
Cyrus Caroom ◽  
Jessica M. Tullar ◽  
E. Garrison Benton ◽  
Jason R. Jones ◽  
Christopher D. Chaput
Keyword(s):  
Surgical Site Infections ◽  
Cervical Fusion ◽  
Vancomycin Powder ◽  
Posterior Cervical Fusion

scholarly journals Experience with intrawound vancomycin powder for posterior cervical fusion surgery

2015 ◽  
Vol 22 (1) ◽  
pp. 26-33 ◽  
Author(s):  
Joel R. Martin ◽  
Owoicho Adogwa ◽  
Christopher R. Brown ◽  
Maragatha Kuchibhatla ◽  
Carlos A. Bagley ◽  
...  
Keyword(s):  
Logistic Regression ◽  
Wound Infection ◽  
Site Infection ◽  
Cervical Fusion ◽  
Fusion Surgery ◽  
Deep Wound Infection ◽  
Deep Wound ◽  
Vancomycin Powder ◽  
Posterior Cervical Fusion ◽  
Propensity Score Adjustment

OBJECT Recent studies have reported that the local delivery of vancomycin powder is associated with a decrease in spinal surgical site infection. This retrospective cohort study compares posterior cervical fusion cases before and after the routine application of spinal vancomycin powder to evaluate the ability of local vancomycin powder to prevent deep wound infection after posterior cervical spinal fusion. METHODS Posterior cervical fusion spinal surgeries performed at a single institution were reviewed from January 2011 to July 2013. Each cohort's baseline characteristics, operative data, and rates of wound infection were compared. Associations between infection and vancomycin powder, with and without propensity score adjustment for risk factors, were determined using logistic regression. RESULTS A total of 289 patients (174 untreated and 115 treated with vancomycin powder) were included in the study. The cohorts were similar in terms of baseline and operative variables. No significant change in deep wound infection rate was seen between the control group (6.9%) and intervention group (5.2%, p = 0.563). Logistic regression, with and without propensity score adjustment, demonstrated that the use of vancomycin powder did not impact the development of surgical site infection (OR 0.743 [95% CI 0.270–2.04], p = 0.564) and (OR 0.583 [95% CI 0.198–1.718], p = 0.328), respectively. CONCLUSIONS Within the context of an ongoing debate on the effectiveness of locally administered vancomycin powder, the authors found no significant difference in the incidence of deep wound infection rates after posterior cervical fusion surgery with routine use of locally applied vancomycin powder. Future prospective randomized series are needed to corroborate these results.

Decreased Risk of Wound Infection After Posterior Cervical Fusion With Routine Local Application of Vancomycin Powder

Spine ◽  
2013 ◽  
Vol 38 (12) ◽  
pp. 991-994 ◽  
Author(s):  
Russell G. Strom ◽  
Donato Pacione ◽  
Stephen P. Kalhorn ◽  
Anthony K. Frempong-Boadu
Keyword(s):  
Wound Infection ◽  
Local Application ◽  
Cervical Fusion ◽  
Vancomycin Powder ◽  
Posterior Cervical Fusion

Crossing the Cervicothoracic Junction During Posterior Cervical Fusion for Myelopathy Is Associated With Superior Radiographic Parameters But Similar Clinical Outcomes

Neurosurgery ◽  
2021 ◽  
Vol 89 (Supplement_2) ◽  
pp. S35-S35
Author(s):  
Andrew K Chan ◽  
Ryan K Badiee ◽  
Joshua Rivera ◽  
Chih-Chang Chang ◽  
Leslie C Robinson ◽  
...  
Keyword(s):  
Clinical Outcomes ◽  
Cervical Fusion ◽  
Cervicothoracic Junction ◽  
Radiographic Parameters ◽  
Posterior Cervical Fusion

scholarly journals The Use of Vancomycin Powder for Surgical Prophylaxis Following Craniotomy

Neurosurgery ◽  
2017 ◽  
Vol 80 (5) ◽  
pp. 754-758 ◽  
Author(s):  
Vinod Ravikumar ◽  
Allen L. Ho ◽  
Arjun V. Pendharkar ◽  
Eric S. Sussman ◽  
Kevin Kwong-hon Chow ◽  
...  
Keyword(s):  
Ad Hoc ◽  
Cost Savings ◽  
Surgical Site Infections ◽  
Control Group ◽  
Infection Prophylaxis ◽  
Potential Cost Saving ◽  
Infection Rates ◽  
Surgical Prophylaxis ◽  
Potential Cost ◽  
Vancomycin Powder

Abstract BACKGROUND: Intrawound vancomycin powder has been studied extensively in spinal fusion surgeries and been found to reduce rates of surgical site infections (SSIs) significantly. Despite its success in spinal surgeries, topical vancomycin has not been extensively studied with respect to cranial neurosurgery. OBJECTIVE: To evaluate the efficacy of intrawound topical vancomycin for prevention of SSIs following open craniotomies. METHODS: We retrospectively analyzed a large series of 350 patients from 2011 to 2015 in a pre/postintervention study of use of topical vancomycin to reduce postoperative craniotomy infection rates. We had a preintervention control group of 225 patients and a postintervention group of 125 patients that received intrawound topical vancomycin. RESULTS: Our preintervention incidence of SSI was 2.2% and this was significantly reduced to 0% following introduction of topical vancomycin (P < .5). An ad hoc cost analysis suggested a cost savings of ${\$}$59 965 with the use of topical vancomycin for craniotomies. CONCLUSION: Our study found a significant reduction in SSI rates after introduction of topical vancomycin. Thus, this simple intervention should be considered in all open craniotomy patients as both infection prophylaxis and a potential cost saving intervention.

Comparison of tension band wiring and lateral mass plating for subaxial posterior cervical fusion

1998 ◽  
Vol 50 (4) ◽  
pp. 323-332 ◽  
Author(s):  
David W. Lowry ◽  
Thomas J. Lovely ◽  
Pawan Rastogi
Keyword(s):  
Tension Band ◽  
Tension Band Wiring ◽  
Lateral Mass ◽  
Cervical Fusion ◽  
Posterior Cervical Fusion

Predictive Risk Factors of Nonhome Discharge Following Elective Posterior Cervical Fusion

2018 ◽  
Vol 119 ◽  
pp. e574-e579 ◽  
Author(s):  
Ivan Ye ◽  
Kevin Phan ◽  
Zoe B. Cheung ◽  
Samuel J.W. White ◽  
Jacqueline Nguyen ◽  
...  
Keyword(s):  
Risk Factors ◽  
Cervical Fusion ◽  
Posterior Cervical Fusion ◽  
Predictive Risk

Reducing surgical site infections following craniotomy: examination of the use of topical vancomycin

2015 ◽  
Vol 123 (6) ◽  
pp. 1600-1604 ◽  
Author(s):  
Kalil G. Abdullah ◽  
Mark A. Attiah ◽  
Andrew S. Olsen ◽  
Andrew Richardson ◽  
Timothy H. Lucas
Keyword(s):  
Primary Outcome ◽  
Surgical Site Infections ◽  
Primary Outcome Measure ◽  
Secondary Outcome ◽  
Time Interval ◽  
Infection Rates ◽  
Skin Flora ◽  
Vancomycin Powder ◽  
Subgaleal Space ◽  
Typical Skin

OBJECT Although the use of topical vancomycin has been shown to be safe and effective for reducing postoperative infection rates in patients after spine surgery, its use in cranial wounds has not been studied systematically. The authors hypothesized that topical vancomycin, applied in powder form directly to the subgaleal space during closure, would reduce cranial wound infection rates. METHODS A cohort of 150 consecutive patients who underwent craniotomy was studied retrospectively. Seventy-five patients received 1 g of vancomycin powder applied in the subgaleal space at the time of closure. This group was compared with 75 matched-control patients who were accrued over the same time interval and did not receive vancomycin. The primary outcome measure was the presence of surgical site infection within 3 months. Secondary outcome measures included tissue pH from a subgaleal drain and vancomycin levels from the subgaleal space and serum. RESULTS Vancomycin was associated with significantly fewer surgical site infections (1 of 75) than was standard antibiotic prophylaxis alone (5 of 75; p < 0.05). Cultures were positive for typical skin flora species. As expected, local measured vancomycin concentrations peaked immediately after surgery (mean ± SD 499 ± 37 μg/ml) and gradually decreased over 12 hours. Vancomycin in the circulating serum remained undetectable. Subgaleal topical vancomycin was associated with a lower incidence of surgical site infections after craniotomy. The authors attribute this reduction in the infection rate to local vancomycin concentrations well above the minimum inhibitory concentration for antimicrobial efficacy. CONCLUSIONS Topical vancomycin is safe and effective for reducing surgical site infections after craniotomy. These data support the need for a prospective randomized examination of topical vancomycin in the setting of cranial surgery.

Short-term outcomes following posterior cervical fusion among octogenarians with cervical spondylotic myelopathy: a NSQIP database analysis

2018 ◽  
Vol 18 (9) ◽  
pp. 1603-1611 ◽  
Author(s):  
Caroline E. Vonck ◽  
Joseph E. Tanenbaum ◽  
Thomas T. Bomberger ◽  
Edward C. Benzel ◽  
Jason W. Savage ◽  
...  
Keyword(s):  
Cervical Spondylotic Myelopathy ◽  
Cervical Fusion ◽  
Database Analysis ◽  
Short Term ◽  
Posterior Cervical Fusion
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