Asian Spine J.  2015 Aug;9(4):517-521. 10.4184/asj.2015.9.4.517.

Efficacy of Antibiotics Sprayed into Surgical Site for Prevention of the Contamination in the Spinal Surgery

• Suh BK
• Moon SH
• Kim TH
• Oh JK
• Kwon YS
• Park JS
• Park MS

• KMID: 2169320
• DOI: http://doi.org/10.4184/asj.2015.9.4.517

Abstract

STUDY DESIGN: Retrospective study. PURPOSE: To evaluate the effect of intraoperative wound application of vancomycin on preventing surgical wound contamination during instrumented lumbar spinal surgery. OVERVIEW OF LITERATURE: Postoperative infection is the one of the most devastating complications of lumbar surgery. There are a few reports showing the benefits of intraoperative wound application of vancomycin during spinal surgery. However, there is no report about the effectiveness of local vancomycin instillation in prevention of surgical wound contamination.
METHODS
Eighty-six patients underwent instrumented lumbar spinal surgery. Mean patient age was 65.19 years (range, 23-83 years). There were 67 females and 19 males. During surgery, vancomycin powder was applied into the surgical site before closure in 43 patients (antibiotic group) and vancomycin powder was not applied into the surgical site before closure in 43 patients (control group). The tip of the surgical drain was cultured to evaluate surgical wound contamination. Erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) were measured on the first, third, seventh, and fourteenth day after the operation.
RESULTS
We found two patients with a positive culture from the tip of surgical drains in the antibiotic group, and one patient with a positive culture from the tip of the surgical drain in the control group. Postoperative ESR and CRP levels did not show significant differences between the two groups. On the third postoperative day, ESR in patients of the antibiotic group was more significantly decreased than that in patients of the control group, while CRP level did not show a significant difference between the two groups.
CONCLUSIONS
There was no evidence to suggest that intraoperative vancomycin application is effective in decreasing the risk of postoperative wound infection after instrumented posterior lumbar fusion surgery.

Keyword

Lumbar spine; Fusion; Vancomycin; Contamination

MeSH Terms

Anti-Bacterial Agents*
Blood Sedimentation
C-Reactive Protein
Female
Humans
Male
Retrospective Studies
Surgical Wound Infection
Vancomycin
Wounds and Injuries
Anti-Bacterial Agents
C-Reactive Protein
Vancomycin