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- Title
Effect of prophylactic intra-operative instillation of vancomycin powder on surgical site infections following spinal surgery: a retrospective case control study.
- Authors
Maajid, Saheel; Ali, Nadeem; Senin; Mir, Ayaz Ali; Motten, Tarsem; Dar, Reyaz Ahmad; Bhat, Mudasir Ahmad
- Abstract
Objectives:The aim of this study was to find effectiveness of intraoperative instillation of crystalline vancomycin powder in posterior spinal surgeries as a prophylaxis in preventing postoperative acute surgical site infections. Background:Every surgical procedure is plagued with the risk of surgical site infection (SSI) despite use of parentral antimicrobial prophylaxis and same holds true for the spinal surgeries. SSI after spinal surgeries adds to patient morbidity and increases the burden on the health care system. Instillation of vancomycin powder in the wound before closure may decrease the incidence of SSI in spinal surgeries. Methods:A retrospective analysis was done from the hospital medical record section about posterior spinal surgical procedures performed from January 2013 till May 2017. In patients operated from January 2015 onwards, intra-wound instillation of vancomycin powder before closure of the wound was done and these patients were allocated to vanco group. While as patients operated before January 2015, where no antibiotic was instilled in the wound, were allocated to non-vanco group. A total of 305 patients were included in this retrospective study with 153 patients belonging to vanco group and 150 to non-vanco group. Results:The difference in the results between the two groups was compared. The two groups were statistically comparable with respect to age, gender, BMI, co-morbidities and surgical procedures. There was a significant reduction of SSI from 11.3% in non-vanco group to2.6% in the vanco group (p = 0.003). Bacteriologically this decrease was significant with respect to Staphylococcal infections from 6.7% to 0.65% (p = 0.005). Conclusion: Intra operative use of vancomycin powder significantly reduces the incidence of SSI in posterior spinal surgeries, especially those caused by staphylococci. MRSA related SSI, which cannot be prevented by routine parentral antimicrobial prophylaxis, are also significantly reduced.
- Subjects
SPINAL surgery; SURGICAL site infections; VANCOMYCIN; DRUG instillation
- Publication
JK Practitioner, 2018, Vol 23, Issue 1/2, p19
- ISSN
0971-8834
- Publication type
Article