Does Intrawound Vancomycin Decrease Postoperative Surgical Site Infection in Spine Surgery: A Retrospective Case-control Study.

IF 1.6 4区医学 Q3 CLINICAL NEUROLOGY

Clinical Spine Surgery Pub Date : 2024-07-01 Epub Date: 2024-02-05 DOI:10.1097/BSD.0000000000001578

Zachariah Pinter, Rachel Honig, Arjun Sebastian, Ahmad Nassr, Brett Freedman, Michael Yaszemski, Paul Huddleston, Elie Berbari, Bradford Currier

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Abstract

Study design: Retrospective Case-Control series.

Objective: The objective of this study is to define the overall postoperative rate of surgical site infection (SSI) in patients undergoing spine surgery and examine the effects of intrawound Vancomycin on postoperative infection rates.

Summary of background data: Surgical site infections (SSI) account for 22% of all health care-associated infections. The use of intrawound Vancomycin in an attempt to reduce the incidence of postoperative SSI has not been sufficiently evaluated in the existing literature.

Methods: All spine surgeries (n=19,081) from our institution were reviewed from 2003 to 2013. All cases of verified SSI were identified from the database. Cases were then matched to controls in a 1:1 fashion based on age, gender, and date of surgery (+/-30 d). Patient demographics, comorbidities, estimated blood loss, duration of surgery, intrawound administration of Vancomycin, and smoking status were evaluated.

Results: At total of 316 cases of SSI after spine surgery were identified, representing an infection rate of 1.7%. The mean follow-up for cases and controls was 31.5 and 41.6 months, respectively. OR for intrawound Vancomycin was 0.44 (95% CI 0.23-0.88, P =0.019). OR for BMI greater than 30 was 1.63 (95% CI 1.04-2.56, P =0.03).

Conclusions: In this large cohort of spine surgery patients, administration of intrawound Vancomycin was associated with a significant reduction in postoperative surgical site infections. Further studies are needed to determine appropriate dosing and application as well as long-term safety in spine surgery.

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鞘内万古霉素能否减少脊柱手术的术后手术部位感染？一项回顾性病例对照研究。

研究设计回顾性病例对照系列研究：本研究的目的是确定脊柱手术患者术后手术部位感染（SSI）的总体发生率，并研究鞘内万古霉素对术后感染率的影响：手术部位感染（SSI）占所有医疗相关感染的 22%。现有文献尚未对使用鞘内万古霉素试图降低术后 SSI 发生率进行充分评估：方法：回顾了我院 2003 年至 2013 年的所有脊柱手术（n=19,081）。从数据库中找出所有经证实的 SSI 病例。然后根据年龄、性别和手术日期（+/-30 d）将病例与对照组进行1:1配对。对患者的人口统计学特征、合并症、估计失血量、手术持续时间、伤口内万古霉素用量和吸烟状况进行了评估：结果：共发现 316 例脊柱手术后 SSI 病例，感染率为 1.7%。病例和对照组的平均随访时间分别为 31.5 个月和 41.6 个月。伤口内万古霉素的OR值为0.44（95% CI 0.23-0.88，P=0.019）。BMI大于30的OR为1.63（95% CI 1.04-2.56，P=0.03）：在这一大型脊柱手术患者队列中，使用万古霉素可显著减少术后手术部位感染。要确定脊柱手术的适当剂量和应用以及长期安全性，还需要进一步的研究。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Clinical Spine Surgery Medicine-Surgery

CiteScore

3.00

自引率

5.30%

发文量

236

期刊介绍： Clinical Spine Surgery is the ideal journal for the busy practicing spine surgeon or trainee, as it is the only journal necessary to keep up to date with new clinical research and surgical techniques. Readers get to watch leaders in the field debate controversial topics in a new controversies section, and gain access to evidence-based reviews of important pathologies in the systematic reviews section. The journal features a surgical technique complete with a video, and a tips and tricks section that allows surgeons to review the important steps prior to a complex procedure. Clinical Spine Surgery provides readers with primary research studies, specifically level 1, 2 and 3 studies, ensuring that articles that may actually change a surgeon’s practice will be read and published. Each issue includes a brief article that will help a surgeon better understand the business of healthcare, as well as an article that will help a surgeon understand how to interpret increasingly complex research methodology. Clinical Spine Surgery is your single source for up-to-date, evidence-based recommendations for spine care.