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논문 기본 정보

자료유형
학술저널
저자정보
Prashant Adhikari (Acibadem Ankara Hospital) Vugar Nabi Nabiyev (Acibadem Ankara Hospital) Sinan Bahadir (Acibadem Ankara Hospital) Selim Ayhan (Acibadem Ankara Hospital) Selcen Yuksel (Yildirim Beyazit University) Selcuk Palaoglu (Acibadem Ankara Hospital) Emre Acaroglu (Ankara Spine Center)
저널정보
대한척추외과학회 Asian Spine Journal Asian Spine Journal Vol.14 No.1
발행연도
2020.1
수록면
72 - 78 (7page)

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Study Design: Retrospective case series with a historical control group. Purpose: To compare the deep wound infection rates in patients undergoing spinal surgery with the application of topical intrawound vancomycin powder (TIVP) in the surgical site in addition to standard systemic prophylaxis with those in a matched historical cohort of patients for whom TIVP was not used. Overview of Literature: Surgical site infection (SSI) after spine surgery is debilitating and is responsible for a significant increase in the health care costs, hospital stay, and morbidities. Although the application of TIVP before surgical closure is a promising method for reducing the SSI rate after spine surgery, its use is controversial, and currently, research trials are focusing on identifying its safety, efficacy, and the potential patient population. Methods: A group of 88 patients who underwent posterior spinal surgery with TIVP administration (treatment group) was compared to a historical control group of 70 patients who had received only standard systemic intravenous prophylaxis (control group) for the analysis of deep SSI rate and the involved organisms. Results: The overall rate of deep SSIs was 2.5% (4/158). All the SSIs were observed in patients who had posterior instrumentation and fusion for ≥3 levels. In the treatment group, the SSI rate was 3.4% (3/88), and the bacteria isolated were Escherichia coli (n=2) and Pseudomonas aeruginosa (n=1). In the control group, the infection rate was 1.4% (1/70), and the isolated bacteria were Morganella morganii and Staphylococcus epidermidis. No statistically significant association was found between the SSI rates of the treatment and control groups. Conclusions: Although the difference in the SSI rates was not statistically significant, the present results suggest that TIVP administration could not reduce the risk of deep SSIs after spinal surgery. Moreover, TIVP administration might also affect the underlying pathogens by increasing the propensity for gram-negative species.
#Infection #Postoperative complications #Spine #Surgical wound infection #Vancomycin

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참고문헌 (23)

참고문헌 신청
Weinstein MA / 2000 / Postoperative spinal wound infection : a review of 2, 391consecutive index procedures / J Spinal Disord 13:422~426 google schola Patel H / 2017 / Burden of surgical site infections associated with select spine operations and involvement of staphylococcus aureus / Surg Infect 18:461~473 google schola Zebala LP / 2014 / Intrawound vancomycin powder eradicates surgical wound contamination : an in vivo rabbit study / J Bone Joint Surg Am 96:46~51 google schola Sweet FA / 2011 / Intrawound application of vancomycin for prophylaxis in instrumented thoracolumbar fusions : efficacy, drug levels, and patient outcomes / Spine 36:2084~2088 google schola Theologis AA / 2014 / Local intrawound vancomycin powder decreases the risk of surgical site infections in complex adult deformity reconstruction : a cost analysis / Spine 39:1875~1880 google schola

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