Local Vancomycin in Prevention of Surgical Site Infection in Spinal Surgeries Systematic Review

Abstract

SIs can lead to greater post-operative morbidity, mortality and healthcare costs. Despite current prophylactic measures, SSIs is still being reported in patients undergoing spine surgery. Local application of vancomycin in spine surgery is a low-cost strategy to help reduce SSIs as it is active against pathogens which might contaminate the wound during spinal surgery. The local application of vancomycin in its powder form ensures adequate surgical site concentrations while minimizing adverse events caused by its systemic distribution. However, several studies revealed contradictory findings concerning the effectiveness of local administration of vancomycin in prevention of SSIs in spinal surgeries. Literature search and filtration on intrawound application of vancomycin in spinal surgeries yielded 9 studies with a total of 46,907 patients. Review of the enrolled studies confirmed that intrawound vancomycin use appears to be safe and effective for reducing postoperative SSIs in spinal surgeries with a low rate of adverse events. However, these studies use different definitions for surgical site infections and different pre-, peri- and postoperative antibiotic regimens. That is why intrawound application of vancomycin in spinal surgeries is recommended to reduce postoperative SSIs and further studies using standardized protocols are needed to confirm findings of the current study