Effect of Intra ‐wound Vancomycin for Spinal Surgery: A Systematic Review and Meta‐analysis

Intra‐site prophylactic vancomycin in spine surgery is an effective method of decreasing the incidence of postsurgical wound infection. However, there are differences in the prophylactic programs used for various spinal surgeries. Thus, this systematic review and meta‐analysis aimed to evaluate the effectiveness of using intra‐wound vancomycin during spinal surgery and to explore the effects of dose‐dependence and the method of administration in a subgroup analysis. A total of 628 citations or studies were searched in PubMed, Ovid, Web of Science, and Google Scholar that were published before August 2016 with the terms “local vancomycin”, “intra‐wound vancomycin”, “intraoperative vancomycin”, “intra‐site vancomycin”, “topical vancomycin”, “spine surgery”, and “spinal surgery”. Finally, 19 retrospective cohort studies and one prospective case study were eligible for inclusion in the systematic review and meta‐analysis. The odds of developing postsurgical wound infection without prophylactic local vancomycin use were 2.83‐fold higher than the odds of experiencing wound infection with the use of intra‐wound vancomycin (95% confidence interval, 2.03–3.95; P = 0.083; I2 = 32.2%). The subgroup analysis including the dosage and the method of administration, revealed different results compared to previous research. The value of I2 in the 1‐g group was 27.2%, which was much lower than in the 2‐g group (I2 = 57.6%). At the same time, ...
Source: Orthopaedic Surgery - Category: Orthopaedics Authors: Tags: REVIEW ARTICLE Source Type: research