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Local vancomycin therapy to reduce surgical site infection in adult spine surgery: a randomized prospective study

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Abstract

Purpose

This prospective randomized controlled trial hypothesizes that intra wound vancomycin reduces postoperative infection.

Methods

In this RCT study, the patients were randomly divided into two groups of treatment and control. In the treatment group, 1–2 g of intra wound vancomycin was used, and no drug was used for the control group. SSI and the type of microorganism causing postoperative infection were assessed at a three-month follow-up. Factors affecting postoperative infection such as age, sex, site of operation, surgical levels, and risk factors affecting postoperative infection, such as diabetes, blood pressure, ischemic heart disease, smoking, blood transfusion, BMI, neurologic deficit, CSF leakage, UTI, COPD and surgery time were examined in two groups.

Results

In this study, 375 patients, including 187patients in the treatment group and 188 patients in the control group, were studied. Among the patients, 228 had surgery without instrumentation, and 147 had surgery with instrumentation. There were 12 cases of SSI in the treatment group and 11 in the control group, and there was no statistically significant difference between the two groups. There was no difference between the two groups with and without instrumentation in the evaluation of postoperative infection. In the subgroups with and without instruments, there was no significant difference between treatment and control groups. Due to the microorganism causing the infection, gram-negative bacteria were more common in the treatment group.

Conclusion

Intra-wound vancomycin has no effect on SSI; in addition, it can increase the rate of gram-negative infections.

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Data availability

The datasets generated for this study are available on request to the corresponding authors.

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Funding

The study received no funding.

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Authors and Affiliations

  1. Clinical Research and Development Unit, Imam Hossein Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran

    Sohrab Salimi & Maryam KhayatKashani

  2. Department of Neurosurgery, Imam Hossein Hospital, Shahid Beheshti University of Medical Sciences, Madani street, Tehran, Iran

    Hamid Reza Khayat Kashani, Shirzad Azhari, Sohrab Sadeghi, Siavash Sheikhghomy & Poorya paryan

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  1. Sohrab Salimi
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  2. Hamid Reza Khayat Kashani
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Correspondence to Hamid Reza Khayat Kashani.

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Salimi, S., Khayat Kashani, H.R., Azhari, S. et al. Local vancomycin therapy to reduce surgical site infection in adult spine surgery: a randomized prospective study. Eur Spine J 31, 454–460 (2022). https://doi.org/10.1007/s00586-021-07050-5

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  • DOI: https://doi.org/10.1007/s00586-021-07050-5

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