LOCAL VANCOMYCIN IN PREVENTION OF SURGICAL SITE INFECTION IN SPINAL SURGERIES

Document Type : Original Article

Authors

Orthopaedic Surgery Department, Faculty of Medicine, Ain Shams University, Cairo, Egypt.

Abstract

Background: SSIs can lead to greater post-operative morbidity, mortality and healthcare costs. Despite current prophylactic measures, SSIs is still being reported in patients undergoing spine surgery. Local application of vancomycin in spine surgery is a low-cost strategy to help reduce SSIs as it is active against pathogens which might contaminate the wound during spinal surgery.
Aim of the Work: A systematic review discussing the effect of Local vancomycin in prevention of surgical site in spinal surgeries.
Patients and Methods: Literature search and filtration on intra- wound application of vancomycin in spinal surgeries yielded 9 studies with a total of 46,907 patients.
Results: Review of the enrolled studies confirmed that intra-wound vancomycin use appears to be safe and effective for reducing postoperative SSIs in spinal surgeries with a low rate of adverse events. However, these studies use different definitions for surgical site infections and different pre-, peri- and postoperative antibiotic regimens. That is why intra wound application of vancomycin in spinal surgeries is recommended to reduce postoperative SSIs and further studies using standardized protocols are needed to confirm findings of the current study.
Conclusion: The different follow-up periods, particularly for patients with short-term follow up, may underestimate the incidence of SSIs and adverse events especially in the vancomycin group.

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