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Intraoperative Vancomycin Powder Reduces Staphylococcus aureus Surgical Site Infections and Biofilm Formation on

James Paul Hovis1, Ryan Montalvo, Dimitrius Marinos

  • 1Department of Orthopaedics, R Adams Cowley Shock Trauma Center, University of Maryland, Baltimore, MD.

Journal of Orthopaedic Trauma
|February 6, 2018
PubMed
Abstract

Insights

Intraoperative vancomycin powder effectively prevented bone infection and implant biofilm formation in a rabbit model. This suggests vancomycin powder is a promising strategy for reducing surgical site infections in clinical settings.

Area of Science:

  • Orthopedic Surgery
  • Infectious Disease
  • Pharmacology

Background:

  • Surgical site infections (SSIs) are a significant complication, particularly in patients with orthopedic implants.
  • Biofilm formation on implants by bacteria like methicillin-resistant Staphylococcus aureus (MRSA) contributes to persistent infections.
  • Effective preventative strategies for SSIs are crucial for patient outcomes and healthcare cost reduction.

Purpose of the Study:

  • To evaluate the efficacy of intraoperative vancomycin powder in preventing SSIs.
  • To assess the prevention of biofilm formation on orthopedic implants in a contaminated animal model.

Main Methods:

  • A rabbit tibial fixation model was established, with surgical sites inoculated with MRSA.
  • Eighteen rabbits were divided into two groups: one receiving intraoperative vancomycin powder, the other serving as a control.
  • Infection and biofilm presence were assessed 2 weeks post-surgery using colony-forming units, radiography, histology, and electron microscopy; serum vancomycin levels were monitored.

Main Results:

  • No bone infections or implant colonization were observed in the vancomycin powder group.
  • The control group experienced a 67% rate of bone infection and implant biofilm formation (P = 0.009).
  • Serum vancomycin levels remained minimal, detected only at 1 and 6 hours post-administration.

Conclusions:

  • Intraoperative vancomycin powder significantly reduced the risk of bone infection and implant biofilm formation in this rabbit model.
  • The localized application of vancomycin powder demonstrated efficacy with minimal systemic absorption.
  • These findings support further investigation into clinical trials for using local vancomycin powder to decrease SSI rates.

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