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No Decrease in Infection Rate with the Use of Local Vancomycin Powder After Partial Hip Replacement in Elderly
H Yener Erken1, Gurdal Nusran1, Doğaç Karagüven2
1Orthopaedics and Traumatology, Canakkale Onsekiz Mart University, Canakkale, TUR.
Cureus
|October 13, 2020
Summary
Local vancomycin powder did not reduce surgical site infections in elderly hip replacement patients. This study found no significant difference in infection rates between vancomycin-treated and non-treated groups.
Area of Science:
- Orthopedic Surgery
- Infectious Disease Prevention
- Pharmacology
Background:
- Surgical site infections (SSIs) are a significant concern, especially in elderly patients with comorbidities undergoing hip replacement.
- Reducing SSIs is crucial for improving patient outcomes and decreasing healthcare costs.
Purpose of the Study:
- To evaluate the efficacy of local intra-wound vancomycin powder (VP) in preventing SSIs after partial hip replacement.
- To assess VP's effectiveness in elderly patients with comorbidities undergoing treatment for intertrochanteric (ITF) or femoral neck fractures (FNF).
Main Methods:
- Retrospective review of 93 patients undergoing partial hip replacement for ITF or FNF.
- Patients were divided into two groups: standard systemic prophylaxis (cefazolin) and standard prophylaxis plus 1g of intra-wound vancomycin powder.
- Inclusion criteria: age 64+ with one or more comorbidities.
Main Results:
- Overall SSI rate was 6.4% (6 out of 93 patients).
- SSI rate in the vancomycin-treated group was 5.7%, and 6.9% in the non-treated group (p=0.498), showing no statistically significant difference.
- Higher SSI incidence was observed in patients with post-operative intensive care unit (ICU) follow-up.
Conclusions:
- Local intra-wound vancomycin powder application was ineffective in reducing SSIs after partial hip replacement in elderly patients with comorbidities.
- Further research may be needed to explore alternative strategies for SSI prevention in this high-risk population.
Keywords:
hip arthroplastylocal applicationpartial hip replacementsurgical site infectionvancomycin powderMore Related Videos
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