Incidence of surgical site infection in patients with spinal surgery and use of topical vancomycin: A cohort study
DOI:
https://doi.org/10.1016/j.rccot.2021.04.003Keywords:
spinal column, arthrodesis, vancomycin, surgical site infectionAbstract
Background: The incidence of infection in spine surgery can be up to 12%; With the use of topical vancomycin, prior to closure, the risk of this condition has been reduced. The aim of the study is to determine the incidence of infection in spinal surgery to which topical vancomycin was applied prior to the closure of an incision in a highly complex institution.
Methods: An observational retrospective cohort study was conducted. Patients undergoing spi- nal surgery with application of topical vancomycin prior to closure between 2014 and 2018 in a third-level institution were included. The patients were followed from the moment of surgery until 3 months post-surgery. Information was collected on age, comorbilities, body mass index, surgical time, intraoperative bleeding, complications, use of drainages.
Results: 130 patients were included, 81 women and 49 men with an average age of 64 years. 95.4% were performed posteriorly with laminectomy, arthrodesis and instrumentation. The ave- rage time was 207 minutes, with a bleeding of 400 mL. Only one patient presented a dura mater rupture. Five patients presented surgical site infection for an incidence of 3.8% (95% CI 1.5% - 8.9%).
Discussion: The use of vancomycin seems to reduce the risk of infection in spinal surgery accor- ding to the incidence of this infection reported in the literature; however, prospective studies or controlled clinical trials are needed to prove the ideal doses of this therapy.
EVIDENCE LEVEL: III.
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