Efficacy of local vancomycin in preventing surgical site infections following spinal instrumentation
Journal Title: International Journal of Orthopaedics Sciences - Year 2018, Vol 4, Issue 3
Abstract
Background: Surgical site infctions is one of the frequently seen complication following instrumented spinal surgeries. Although numerous prophylactic measures have been tried out to prevent surgical site infections, it still remains a concern. Local use of powdered vancomycin is one of the newer method which is being tried all over the world to reduce the rates of infection. Materials and methods: The study was conducted in our Institute in a prospective manner from January 2012 to June 2017. A total of 80 patients who underwent spinal instrumentation for various indications were included in the study. Patients were divided into two groups, first group a Control Group(CG) and second group- Vancomycin Group (VG). Both the groups comprised of 40 patients each. One gram of powdered vancomycin was impregnated below the fascial layer after completion of surgery in patients who belonged to Vancomycin Group. Results: There found to be no statistical significant difference between the groups for the following variables: age, sex, operating time and blood loss. Infection rates in the two groups were compared. There were total 6 cases of infection. 5 out of 40 (12.5%) patients in the control group had either superficial or deep infections. While only one patient (2.5%) belonged to vancomycin group had infection, that too it was a superficial infection. Threre was a statistically significant reduction in the rate of infection in the vancomycin group on comparing with the control group when 'p' value was calculated, with a value of < 0.001. Conclusion: Use of local powdered form of vancomycin following spinal instrumentation surgeries is an effective prophylactic method in reducing the rates of infection. However, further randomized double blind studies with larger sample size is needed.
Authors and Affiliations
Dr. Madhuchandra P, Dr. Shravya S Rao, Dr. Raju KP, Dr. Pawankumar KM, Dr. Nandeesh
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