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Infectious Prophylaxis with Intrawound Vancomycin Powder in Orthopedic Surgeries: Systematic Review with
David Sadigursky1, Mariana Drummond Sousa1, Yasmin Galvão Linhares Cajaíba2
1Clínica Ortopédica Traumatológica, Centro de Estudos em Ortopedia e Traumatologia (COT-CEOT), Salvador, BA, Brasil.
Revista Brasileira De Ortopedia
|December 26, 2019
Summary
Intra-wound vancomycin powder significantly reduces surgical site infections (SSI) in spine surgeries. This meta-analysis found a protective effect, lowering SSI rates in patients receiving vancomycin prophylaxis.
Area of Science:
- Orthopedic Surgery
- Infectious Disease Prevention
- Pharmacology
Background:
- Surgical site infections (SSI) remain a significant challenge in orthopedic surgery, despite existing preventative strategies.
- Reducing SSI is crucial for decreasing patient morbidity, mortality, and healthcare costs.
Purpose of the Study:
- To evaluate the efficacy of intra-wound vancomycin powder for SSI prophylaxis in orthopedic procedures.
- Specifically assess its impact on spine surgery outcomes.
Main Methods:
- Systematic review and meta-analysis following PRISMA-P 2015 guidelines.
- Included 7 controlled studies (4 prospective, 3 retrospective) involving 6,944 patients undergoing spine surgery.
- Compared SSI rates between patients receiving intra-wound vancomycin and a control group.
Main Results:
- The intervention group (vancomycin) had a lower SSI rate (2.04%) compared to the control group (3.75%).
- Meta-analysis revealed a statistically significant protective effect of intra-wound vancomycin powder against SSI in spine surgery (RR 0.59, 95% CI 0.35-0.98).
Conclusions:
- Prophylactic intra-wound vancomycin powder demonstrates a protective effect against SSI in spine surgeries.
- Further prospective trials are recommended to confirm its broader utility in orthopedic surgery.
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