Volume 3, Issue 3 (12-2017)                   IrJNS 2017, 3(3): 89-94 | Back to browse issues page

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Tabesh H, Kamangar M, Tabesh A, Rastgoo A, Mohammadhosseini E, Raeissi-dehkordi M. The Effect of Applying Topical Vancomycin Powder on Prevention of Surgical Site Infection in Patients Undergoing Spinal Surgery Using Implants . IrJNS. 2017; 3 (3) :89-94
URL: http://irjns.org/article-1-90-en.html
1- Professor Department of Neurosurgery, School of Medicine, Al-Zahra Hospital, Isfahan University of Medical Sciences, Isfahan, Iran
2- MD Department of Neurosurgery, School of Medicine, Al-Zahra Hospital, Isfahan University of Medical Sciences, Isfahan, Iran , dr_mkamangar@yahoo.com
3- Department of Biochemistry, University of Washington, Seattle, Washington, United States
4- Department of Neurosurgery, School of Medicine, Al-Zahra Hospital, Isfahan University of Medical Sciences, Isfahan, Iran
5- Department of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
Abstract:   (260 Views)
Background and Aim: Surgical Site Infection (SSI) is one of the most important complications after spine surgeries. Different methods have been proposed to prevent this type of infection. The present study was performed to evaluate the effect of applying topical vancomycin powder on prevention of SSI in patients undergoing spinal surgery using implants in Al-Zahra Hospital, Isfahan, Iran from February 2015 to June 2016.
Methods and Materials/Patients: In this clinical trial, 100 patients candidate for spinal surgery with implants were divided into two groups using randomization technique including 50 patients in each group. Vancomycin powder solved in 20cc N/S serum was flushed over all layers of the surgical wound in the case group and in the control group sterile normal saline solution was used. Patients were examined at discharge and three months after surgery for ruling out surgical site infection. SSIs following spine surgery can be superficial, characterized by obvious wound drainage and erythema or it can be deep infections disseminating under the fascia which may lead to discitis, epidural abscess, and spondylitis.
Results: One case of SSI was observed in the control group who was 83 years old. The mean age of all patients was 51.9±14.5 years old. The duration of surgery in this patient was 5 hours. The mean duration of surgery was 3.41±0.73 hours. The length of implant, BMI, sex, underlying diseases and other risk factors (diabetes and hypertension) did not affect the rate of infection.
Conclusion: Even though topical antibiotics seem to be effective on controlling SSI but our finding did not support this hypothesis. The authors would like to suggest that keeping routine strict sterility strategies during spine operations is effective enough in preventing surgical site infection.
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Type of Study: Research | Subject: Gamma Knife Radiosurgery

References
1. Schuster JM, Rechtine G, Norvell DC, Dettori JR. The influence of perioperative risk factors and therapeutic interventions on infection rates after spine surgery: A systematic review. Spine. 2010; 35(9S):S125-37. doi: 10.1097/brs.0b013e3181d8342c [DOI:10.1097/BRS.0b013e3181d8342c]
2. Fan Y, Wei Z, Wang W, Tan L, Jiang H, Tian L, et al. The incidence and distribution of surgical site infection in mainland China: A meta-analysis of 84 prospective observational studies. Scientific Reports. 2014; 4(1). doi: 10.1038/srep06783 [DOI:10.1038/srep06783]
3. ETHICON. Comprehensive Approach to Prevention surgical-Site infections. Journal of Neurosurgery. 2004; 54(4):54.
4. Cirak B, Alptekin M, Palaoglu S, Ozcan OE, Ozgen T. Surgical therapy for lumbar spinal stenosis: evaluation of 300 cases. Neurosurgical Review. 2001; 24(2-3):80–2. doi: 10.1007/pl00014585 [DOI:10.1007/PL00014585]
5. Berger E. Late postoperative results in 1000 work related lumbar spine conditions. Surgical Neurology. 2000; 54(2):101–8. doi: 10.1016/s0090-3019(00)00283-4 [DOI:10.1016/S0090-3019(00)00283-4]
6. Heshmati R. [Iranian generic pharmacopeia (Persian)]. Tehran: Hejrat; 2006.
7. Traynelis V, Kasliwal M, Tan L. Infection with spinal instrumentation: Review of pathogenesis, diagnosis, prevention, and management. Surgical Neurology International. 2013; 4(6):392. doi: 10.4103/2152-7806.120783 [DOI:10.4103/2152-7806.120783]
8. Bakhsheshian J, Dahdaleh NS, Lam SK, Savage JW, Smith ZA. The use of vancomycin powder in modern spine surgery: systematic review and meta-analysis of the clinical evidence. World Neurosurgery. 2015; 83(5):816–23. doi: 10.1016/j.wneu.2014.12.033 [DOI:10.1016/j.wneu.2014.12.033]
9. Kang DG, Holekamp TF, Wagner SC, Lehman RA. Intrasite vancomycin powder for the prevention of surgical site infection in spine surgery: A systematic literature review. The Spine Journal. 2015; 15(4):762–70. doi: 10.1016/j.spinee.2015.01.030 [DOI:10.1016/j.spinee.2015.01.030]
10. Cheung JPY, Luk KDK. Complications of anterior and posterior cervical spine surgery. Asian Spine Journal. 2016; 10(2):385-400. doi: 10.4184/asj.2016.10.2.385 [DOI:10.4184/asj.2016.10.2.385]

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