Vancomycin Powder Regimen for Prevention of Surgical Site Infection in Complex Spine Surgeries

Michael Van Hal, Joon Lee, Dann Laudermilch, Chinedu Nwasike, James Kang

Research output: Contribution to journalReview article

16 Citations (Scopus)

Abstract

Study Design: In total, 496 patients of a single surgeon cohort examining the surgical-site infection (SSI) rates with the addition of vancomycin powder in both diabetic and revision spine surgery cases. A historical control group of 652 patients were compared from the same surgeon over an earlier time period before the inception of using vancomycin powder prophylaxis. Objective: The objective of this study was to describe and compare the rates of infection in high-risk patient populations while using vancomycin powder. Summary of Background Data: Vancomycin powder may not decrease an already low rate of infection. Therefore, use of vancomycin powder in high-risk patients with a higher rate of infection would potentially show benefit of vancomycin powder. Materials and Methods: In total, 496 patient charts were collected from a database of cases. Patients were included in the cohort if they had revision spinal operation or if they were diabetic. Patients in the time period July 2010 to August 2013 were included in the vancomycin protocol where 1 g of vancomycin powder was added to the wound before wound closure. Cases were considered positive if there was a positive culture or if there was sufficient clinical suspicion to treat. As a control to this cohort, 692 charts were reviewed from a earlier time period of the same surgeon and institution. Results: In total, 28 patients of 496 (5.6%) patients in the cohort returned to the operating room for seroma, hematoma, draining wound, or infection. Sixteen of these patients (16/496, 3.2%) had a culture positive infection or were treated as an infection. This rate was significantly lower than the historical rate before the protocol. Conclusions: Although vancomycin does seem to be useful in decreasing SSIs, it is not a panacea. SSIs in high-risk patients were not completely eliminated by the vancomycin protocol.

Original languageEnglish (US)
Pages (from-to)E1062-E1065
JournalClinical Spine Surgery
Volume30
Issue number8
DOIs
StatePublished - Jan 1 2017

Fingerprint

Surgical Wound Infection
Vancomycin
Powders
Spine
Infection
Seroma
Wounds and Injuries
Wound Infection
Operating Rooms
Reoperation
Hematoma

Keywords

  • infection
  • revision surgery
  • surgical-site infection
  • vancomycin

ASJC Scopus subject areas

  • Surgery
  • Orthopedics and Sports Medicine
  • Clinical Neurology

Cite this

Vancomycin Powder Regimen for Prevention of Surgical Site Infection in Complex Spine Surgeries. / Van Hal, Michael; Lee, Joon; Laudermilch, Dann; Nwasike, Chinedu; Kang, James.

In: Clinical Spine Surgery, Vol. 30, No. 8, 01.01.2017, p. E1062-E1065.

Research output: Contribution to journalReview article

Van Hal, Michael ; Lee, Joon ; Laudermilch, Dann ; Nwasike, Chinedu ; Kang, James. / Vancomycin Powder Regimen for Prevention of Surgical Site Infection in Complex Spine Surgeries. In: Clinical Spine Surgery. 2017 ; Vol. 30, No. 8. pp. E1062-E1065.
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abstract = "Study Design: In total, 496 patients of a single surgeon cohort examining the surgical-site infection (SSI) rates with the addition of vancomycin powder in both diabetic and revision spine surgery cases. A historical control group of 652 patients were compared from the same surgeon over an earlier time period before the inception of using vancomycin powder prophylaxis. Objective: The objective of this study was to describe and compare the rates of infection in high-risk patient populations while using vancomycin powder. Summary of Background Data: Vancomycin powder may not decrease an already low rate of infection. Therefore, use of vancomycin powder in high-risk patients with a higher rate of infection would potentially show benefit of vancomycin powder. Materials and Methods: In total, 496 patient charts were collected from a database of cases. Patients were included in the cohort if they had revision spinal operation or if they were diabetic. Patients in the time period July 2010 to August 2013 were included in the vancomycin protocol where 1 g of vancomycin powder was added to the wound before wound closure. Cases were considered positive if there was a positive culture or if there was sufficient clinical suspicion to treat. As a control to this cohort, 692 charts were reviewed from a earlier time period of the same surgeon and institution. Results: In total, 28 patients of 496 (5.6{\%}) patients in the cohort returned to the operating room for seroma, hematoma, draining wound, or infection. Sixteen of these patients (16/496, 3.2{\%}) had a culture positive infection or were treated as an infection. This rate was significantly lower than the historical rate before the protocol. Conclusions: Although vancomycin does seem to be useful in decreasing SSIs, it is not a panacea. SSIs in high-risk patients were not completely eliminated by the vancomycin protocol.",
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