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Effect of Using Local Intrawound Vancomycin Powder in Addition to Intravenous Antibiotics in Posterior Lumbar Surgery: Midterm Result in a Single-Center Study

OBJECTIVE: We conducted this study to report the efficacy of local application of vancomycin powder in the setting of surgical site infection (SSI) of posterior lumbar surgical procedures and to figure out risk factors of SSIs. METHODS: From February 2013 to December 2013, SSI rates following 275 po...

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Autores principales: Lee, Gun-Ill, Bak, Koang Hum, Chun, Hyoung-Joon, Choi, Kyu-Sun
Formato: Online Artículo Texto
Lenguaje:English
Publicado: The Korean Spinal Neurosurgery Society 2016
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4949166/
https://www.ncbi.nlm.nih.gov/pubmed/27437012
http://dx.doi.org/10.14245/kjs.2016.13.2.47
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author Lee, Gun-Ill
Bak, Koang Hum
Chun, Hyoung-Joon
Choi, Kyu-Sun
author_facet Lee, Gun-Ill
Bak, Koang Hum
Chun, Hyoung-Joon
Choi, Kyu-Sun
author_sort Lee, Gun-Ill
collection PubMed
description OBJECTIVE: We conducted this study to report the efficacy of local application of vancomycin powder in the setting of surgical site infection (SSI) of posterior lumbar surgical procedures and to figure out risk factors of SSIs. METHODS: From February 2013 to December 2013, SSI rates following 275 posterior lumbar surgeries of which intrawound vancomycin powder was used in combination with intravenous antibiotics (Vanco group) were assessed. Compared with 296 posterior lumbar procedures with intravenous antibiotic only group from February 2012 to December 2012 (non-Vanco group), various infection rates were assessed. Univariate and multivariate analysis to figure out risk factors of infection among Vanco group were done. RESULTS: Statistically significant reduction of SSI in Vanco group (5.5%) from non-Vanco group (10.5%) was confirmed (p=0.028). Mean follow-up period was 8 months. Rate of acute staphylococcal SSIs reduced statistically significantly to 4% compared to 7.4% of non-Vanco group (p=0.041). Deep staphylococcal infection decreased to 2 compared to 8 and deep methicillin-resistant Staphylococcus aureus infection also decreased to 1 compared to 5 in non-Vanco group. No systemic complication was observed. Statistically significant risk factors associated with SSI were diabetes mellitus, history of cardiovascular disease, length of hospital stay, number of instrumented level and history of previous surgery. CONCLUSION: In this series of 571 patients, intrawound vancomycin powder usage resulted in significant decrease in SSI rates in our posterior lumbar surgical procedures. Patients at high risk of infection are highly recommended as a candidate for this technique.
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spelling pubmed-49491662016-07-19 Effect of Using Local Intrawound Vancomycin Powder in Addition to Intravenous Antibiotics in Posterior Lumbar Surgery: Midterm Result in a Single-Center Study Lee, Gun-Ill Bak, Koang Hum Chun, Hyoung-Joon Choi, Kyu-Sun Korean J Spine Clinical Article OBJECTIVE: We conducted this study to report the efficacy of local application of vancomycin powder in the setting of surgical site infection (SSI) of posterior lumbar surgical procedures and to figure out risk factors of SSIs. METHODS: From February 2013 to December 2013, SSI rates following 275 posterior lumbar surgeries of which intrawound vancomycin powder was used in combination with intravenous antibiotics (Vanco group) were assessed. Compared with 296 posterior lumbar procedures with intravenous antibiotic only group from February 2012 to December 2012 (non-Vanco group), various infection rates were assessed. Univariate and multivariate analysis to figure out risk factors of infection among Vanco group were done. RESULTS: Statistically significant reduction of SSI in Vanco group (5.5%) from non-Vanco group (10.5%) was confirmed (p=0.028). Mean follow-up period was 8 months. Rate of acute staphylococcal SSIs reduced statistically significantly to 4% compared to 7.4% of non-Vanco group (p=0.041). Deep staphylococcal infection decreased to 2 compared to 8 and deep methicillin-resistant Staphylococcus aureus infection also decreased to 1 compared to 5 in non-Vanco group. No systemic complication was observed. Statistically significant risk factors associated with SSI were diabetes mellitus, history of cardiovascular disease, length of hospital stay, number of instrumented level and history of previous surgery. CONCLUSION: In this series of 571 patients, intrawound vancomycin powder usage resulted in significant decrease in SSI rates in our posterior lumbar surgical procedures. Patients at high risk of infection are highly recommended as a candidate for this technique. The Korean Spinal Neurosurgery Society 2016-06 2016-06-30 /pmc/articles/PMC4949166/ /pubmed/27437012 http://dx.doi.org/10.14245/kjs.2016.13.2.47 Text en Copyright © 2016 The Korean Spinal Neurosurgery Society http://creativecommons.org/licenses/by-nc/4.0/ This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Clinical Article
Lee, Gun-Ill
Bak, Koang Hum
Chun, Hyoung-Joon
Choi, Kyu-Sun
Effect of Using Local Intrawound Vancomycin Powder in Addition to Intravenous Antibiotics in Posterior Lumbar Surgery: Midterm Result in a Single-Center Study
title Effect of Using Local Intrawound Vancomycin Powder in Addition to Intravenous Antibiotics in Posterior Lumbar Surgery: Midterm Result in a Single-Center Study
title_full Effect of Using Local Intrawound Vancomycin Powder in Addition to Intravenous Antibiotics in Posterior Lumbar Surgery: Midterm Result in a Single-Center Study
title_fullStr Effect of Using Local Intrawound Vancomycin Powder in Addition to Intravenous Antibiotics in Posterior Lumbar Surgery: Midterm Result in a Single-Center Study
title_full_unstemmed Effect of Using Local Intrawound Vancomycin Powder in Addition to Intravenous Antibiotics in Posterior Lumbar Surgery: Midterm Result in a Single-Center Study
title_short Effect of Using Local Intrawound Vancomycin Powder in Addition to Intravenous Antibiotics in Posterior Lumbar Surgery: Midterm Result in a Single-Center Study
title_sort effect of using local intrawound vancomycin powder in addition to intravenous antibiotics in posterior lumbar surgery: midterm result in a single-center study
topic Clinical Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4949166/
https://www.ncbi.nlm.nih.gov/pubmed/27437012
http://dx.doi.org/10.14245/kjs.2016.13.2.47
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