The Utility of Vancomycin Powder in Reducing Surgical Site Infections in Deep Brain Stimulation Surgery.

Abstract

The impact of vancomycin powder on reducing postoperative surgical site infections (SSIs) in spine surgery has been studied extensively and is considered standard of care at many institutions. More recently, vancomycin powder has been shown to reduce SSI in cranial neurosurgery; however, limited studies have been performed assessing its impact in reducing SSIs in deep brain stimulation (DBS) surgery. To investigate the use of vancomycin powder as an adjunct to the current antibiotic prophylaxis regimen in DBS surgery in a large cohort of patients. All patients undergoing DBS-lead implantation surgery and chest generator placement or exchange were analyzed prior to and after the implementation of intrawound vancomycin powder, and the impact on infection rate and any complications were subsequently examined. From 2015 to 2017, a total of 419 consecutive patients (159 in the pretreatment group, 260 in the post-treatment group) were included in the study. The rate of SSI prior to implementation of intrawound vancomycin was 3.1% (n=5), which was reduced to 0.38% (n=1) in the post-treatment group. No complications were noted as a direct result of using vancomycin powder. Given its relatively low cost and side effect profile, the use of vancomycin powder may be an effective adjunct in reducing the rate of SSI in DBS surgery.