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Intrawound application of vancomycin reduces wound infection after open release of post-traumatic stiff elbows: a
Hede Yan1, Jin He2, Shuai Chen2
1Department of Orthopaedics, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, China; Division of Plastic and Hand Surgery, Department of Orthopaedics, The Second Affiliated Hospital of Wenzhou Medical University, Wenzhou, China.
Background:
With the improvements in wound healing through the use of intravenous prophylactic antibiotics and technical refinements, postoperative elbow infections have become less common but still occur in certain elective elbow surgeries. The objective of this study was to evaluate the safety and efficacy of prophylactic application of vancomycin into the operative site to reduce the incidence of infection after the open release of post-traumatic stiff elbows.
Methods:
A retrospective review of 272 such patients during a 4-year period was performed. In the control group (93 patients), simple prophylaxis with standard intravenous antibiotics was performed; in the vancomycin group (179 patients), vancomycin powder was applied directly into the wound before closure along with standard intravenous prophylaxis.
Results:
After a follow-up of at least 6 months, the control group was found to have 6 infections (6.45%; confidence interval: 2.40%-13.52%) compared with none (0%; confidence interval: 0-2%.04%) in the vancomycin group, which was a statistically significant difference (P = .0027). No adverse effects were documented from the direct use of the vancomycin powder.
Conclusions:
The local application of vancomycin powder may be a promising means of preventing postoperative elbow infections after elbow release in patients with post-traumatic elbow stiffness.
