Powdered Vancomycin as Preventive Treatment in Lumbar Surgical Wound Infection

Abstract

Summary: Due to its pharmacodynamic capabilities and its properties at the cell membrane level, vancomycin is considered one of the glycopeptides for clinical use as first-line treatment against most Gram-positive germs. Objective: To analyze the efficacy of topical vancomycin in the prevention of infections at the surgical wound level in spinal surgery. Material and methods: A non-randomized, observational and comparative cohort study of 60 patients with instrumented lumbar spine surgery was carried out in the period between June 2021 and june 2022. In 30 cases with placement of 1 g of topical vancomycin group 1, and 30 did not Group 2, in a nonrandomized manner. Patients were followed up during the first 90 postoperative days. Results: The relationship between vancomycin-infection was not statistically significant, 3 cases of wound infection were identified in the group without vancomycin, it was found that the factor of age over 50 years and Diabetic or immunosuppressed and obesity were predisposing causes respectively, although without p ≤ 0.05, another finding was the RR 2.0208 in an instrumented lumbar level but without significant difference; the main characteristics in the 3 patients with wound infection were only present in the group without vancomycin, identifying. Conclusions: There is no statistical significance in our study that topical vancomycin plays a fundamental role in the prevention of infections at the surgical wound level in spinal surgery. However, it is important to note that all the infected patients in this study belonged to group 2 (without the use of vancomycin).