Prophylactic Intrawound Application of Vancomycin Powder in Instrumented Spinal Fusion Surgery.
10.14245/kjs.2013.10.3.121
- Author:
Hyun Su KIM
1
;
Sang Gu LEE
;
Woo Kyung KIM
;
Chan Woo PARK
;
Seong SON
Author Information
1. Department of Neurosurgery, Gachon University Gil Medical Center, Incheon, Korea. samddal@gilhospital.com
- Publication Type:Comparative Study ; Original Article
- Keywords:
Wound infection;
Spine;
Instrumentation;
Vancomycin
- MeSH:
Cefazolin;
Cohort Studies;
Comorbidity;
Drainage;
Humans;
Incidence;
Retrospective Studies;
Smoke;
Smoking;
Spinal Fusion*;
Spine;
Vancomycin*;
Wound Infection
- From:Korean Journal of Spine
2013;10(3):121-125
- CountryRepublic of Korea
- Language:English
-
Abstract:
OBJECTIVE: We evaluated the effect of intrawound application of vancomycin powder for infection prophylaxis in wounds caused by instrumented spinal surgery. METHODS: From July 2012 to December 2012, 74 instrumented spinal fusion procedures were performed by 1 neurosurgeon at a single institute. We divided the patients into 2 groups, depending on the use of local application of vancomycin powder: Group A (intrawound application of vancomycin powder with perioperative intravenous cefazolin) and Group B (perioperative intravenous cefazolin alone). A retrospective cohort comparative study was conducted between the 2 groups. The age, sex, comorbidities, smoking, surgical procedure, and surgical site infection (SSI) of consecutive patients were analyzed. RESULTS: Among the 74 patients, 34 patients were assigned to group A and 40 patients to group B. No wound infections were found in group A. However, in group B, 5 cases of SSI (12.5%) were found. A statistically significant reduction in SSI incidence was observed in group A (p<0.033). The 5 cases of SSI in group B consisted of 3 cases of deep wound infection and 2 cases of superficial wound infection. All SSIs were found in cases of posterior approach surgery and tended to be more frequent in older patients. CONCLUSION: Adjunctive intrawound local application of vancomycin powder is a simple uncomplicated procedure and can result in a significant reduction of SSI in instrumented spinal fusions. Furthermore, culture of the drainage tip is very important for confirmation of deep wound infection.
