Surgical site infection prophylaxis with intra-wound vancomycin powder for uninstrumented spine surgeries: a meta-analysis

Surgical site infection prophylaxis with intra-wound vancomycin powder for uninstrumented spine surgeries: a meta-analysis

Purpose It is unclear if intra-wound vancomycin powder significantly reduces the infection rate for uninstrumented spine surgery. The purpose of this study is to compare the rate of surgical site infection (SSI) in uninstrumented spine surgery that used vancomycin powder against controls. Methods A...

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Bibliographic Details
Published in:European spine journal Vol. 32; no. 12; pp. 4259 - 4264
Main Authors: Zale, Connor, Nicholes, Marc, Hu, Serena, Cage, JMatthew
Format: Journal Article
Language:English
Published: Berlin/Heidelberg Springer Berlin Heidelberg 01-12-2023
Springer Nature B.V
Subjects:
Anti-Bacterial Agents - therapeutic use
Antibiotic Prophylaxis
Back surgery
Bone surgery
Humans
Medicine
Medicine & Public Health
Neurosurgery
Original Article
Powder
Powders - therapeutic use
Prophylaxis
Retrospective Studies
Spine
Spine - surgery
Surgical Orthopedics
Surgical site infections
Surgical Wound Infection - drug therapy
Surgical Wound Infection - epidemiology
Surgical Wound Infection - prevention & control
Vancomycin
Vancomycin - therapeutic use
Wound infection
Infection
Vancomycin
Uninstrumented
Spine
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Summary:Purpose It is unclear if intra-wound vancomycin powder significantly reduces the infection rate for uninstrumented spine surgery. The purpose of this study is to compare the rate of surgical site infection (SSI) in uninstrumented spine surgery that used vancomycin powder against controls. Methods A search was performed on PUBMED/MEDLINE, Cochrane Database and Embase on 14 October 2022. Search keywords were “vancomycin, spine surgery, uninstrumented and spinal surgery.” Instrumented cases were excluded. Type of surgery, type of treatment and incidence of infection among experimental or control were recorded. Results 288 articles were obtained from a literature search. 16 studies met inclusion criteria. 6/16 studies that reported on the infection rate using vancomycin were obtained. There were 1376 control cases with 20 cases of post-operative infection (1.45% overall). There were 795 cases that received prophylactic intra-wound vancomycin powder with 10 cases of infection reported (1.26%). There was no significant difference in infections between cases that received vancomycin compared to control. On subgroup analysis, studies that had a high rate of infection (Strom and Cannon) had a significant difference on the rate of infection with the use of vancomycin compared to control. Discussion and conclusion The current study was unable to conclude that vancomycin decreased the rate of surgical site infections. Vancomycin use may be useful in populations that have a high rate of infection. Limitations in this study include the small number of studies that report on the use of vancomycin on uninstrumented spine surgery.
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SourceType-Scholarly Journals-1
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ISSN:0940-6719
1432-0932
DOI:10.1007/s00586-023-07897-w