Infectious Prophylaxis with Intrawound Vancomycin Powder in Orthopedic Surgeries: Systematic Review with Meta-Analysis
Abstract Despite many existing strategies used to reduce the rates of surgical site infection (SSI), these are still fairly frequent complications that pose a challenge for orthopedic surgeons. Therefore, the search for more effective methods of perioperative infection prophylaxis became a main subj...
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| Format: | Article |
| Language: | English |
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Thieme Revinter Publicações Ltda.
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| Series: | Revista Brasileira de Ortopedia |
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| Online Access: | http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0102-36162019000600617&tlng=pt |
| _version_ | 1797225736632795136 |
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| author | David Sadigursky Mariana Drummond Sousa Yasmin Galvão Linhares Cajaíba Rodrigo Rêgo Martins Diogo Maciel Vieira Lobão |
| author_facet | David Sadigursky Mariana Drummond Sousa Yasmin Galvão Linhares Cajaíba Rodrigo Rêgo Martins Diogo Maciel Vieira Lobão |
| author_sort | David Sadigursky |
| collection | DOAJ |
| description | Abstract Despite many existing strategies used to reduce the rates of surgical site infection (SSI), these are still fairly frequent complications that pose a challenge for orthopedic surgeons. Therefore, the search for more effective methods of perioperative infection prophylaxis became a main subject of research, with the goal of decreasing postoperative morbidity, mortality, and costs. Thus, the present study sought to assess the effectiveness of intra-wound vancomycin powder in orthopedic surgery SSI prophylaxis. A systematic review and meta-analysis study was conducted using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Protocols 2015 (PRISMA-P 2015). A comprehensive literature search was performed to identify controlled studies on the rates of SSI with or without the local use of vancomycin powder. Exclusion and inclusion criteria were applied. A meta-analysis with random effects was performed. Out of 412 titles that met the criteria, 7 studies regarding spine surgery were included: 4 prospective and 3 retrospective studies. A total of 6,944 cases were identified, and they were divided into 2 groups: the control group (3,814 patients), to whom intrawound vancomycin was not administered, and the intervention group (3,130 patients), to who vancomycin was administered locally. We observed that 64 (2.04%) patients in the intervention group developed SSI, in contrast to 144 (3.75%) patients in the control group. The results of the meta-analysis showed that the local use of vancomycin powder had an statistically significant protective effect against SSI in cases of spine surgery, with a relative risk (RR) of 0.59 and a 95% confidence interval (95%CI) of 0.35-0.98. The use of prophylactic intrawound vancomycin powder has a protective effect against SSI in spine surgeries; however, further prospective trials are needed to endorse its use in orthopedic surgeries. |
| first_indexed | 2024-03-08T07:56:26Z |
| format | Article |
| id | doaj.art-1ae8218d0f9145d2856b10429b2036ca |
| institution | Directory Open Access Journal |
| issn | 1982-4378 |
| language | English |
| last_indexed | 2024-04-24T14:13:45Z |
| publisher | Thieme Revinter Publicações Ltda. |
| record_format | Article |
| series | Revista Brasileira de Ortopedia |
| spelling | doaj.art-1ae8218d0f9145d2856b10429b2036ca2024-04-03T08:57:22ZengThieme Revinter Publicações Ltda.Revista Brasileira de Ortopedia1982-437810.1016/j.rbo.2017.12.003Infectious Prophylaxis with Intrawound Vancomycin Powder in Orthopedic Surgeries: Systematic Review with Meta-AnalysisDavid SadigurskyMariana Drummond SousaYasmin Galvão Linhares CajaíbaRodrigo Rêgo MartinsDiogo Maciel Vieira LobãoAbstract Despite many existing strategies used to reduce the rates of surgical site infection (SSI), these are still fairly frequent complications that pose a challenge for orthopedic surgeons. Therefore, the search for more effective methods of perioperative infection prophylaxis became a main subject of research, with the goal of decreasing postoperative morbidity, mortality, and costs. Thus, the present study sought to assess the effectiveness of intra-wound vancomycin powder in orthopedic surgery SSI prophylaxis. A systematic review and meta-analysis study was conducted using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Protocols 2015 (PRISMA-P 2015). A comprehensive literature search was performed to identify controlled studies on the rates of SSI with or without the local use of vancomycin powder. Exclusion and inclusion criteria were applied. A meta-analysis with random effects was performed. Out of 412 titles that met the criteria, 7 studies regarding spine surgery were included: 4 prospective and 3 retrospective studies. A total of 6,944 cases were identified, and they were divided into 2 groups: the control group (3,814 patients), to whom intrawound vancomycin was not administered, and the intervention group (3,130 patients), to who vancomycin was administered locally. We observed that 64 (2.04%) patients in the intervention group developed SSI, in contrast to 144 (3.75%) patients in the control group. The results of the meta-analysis showed that the local use of vancomycin powder had an statistically significant protective effect against SSI in cases of spine surgery, with a relative risk (RR) of 0.59 and a 95% confidence interval (95%CI) of 0.35-0.98. The use of prophylactic intrawound vancomycin powder has a protective effect against SSI in spine surgeries; however, further prospective trials are needed to endorse its use in orthopedic surgeries.http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0102-36162019000600617&tlng=ptvancomycinsurgical wound infectionorthopedics |
| spellingShingle | David Sadigursky Mariana Drummond Sousa Yasmin Galvão Linhares Cajaíba Rodrigo Rêgo Martins Diogo Maciel Vieira Lobão Infectious Prophylaxis with Intrawound Vancomycin Powder in Orthopedic Surgeries: Systematic Review with Meta-Analysis Revista Brasileira de Ortopedia vancomycin surgical wound infection orthopedics |
| title | Infectious Prophylaxis with Intrawound Vancomycin Powder in Orthopedic Surgeries: Systematic Review with Meta-Analysis |
| title_full | Infectious Prophylaxis with Intrawound Vancomycin Powder in Orthopedic Surgeries: Systematic Review with Meta-Analysis |
| title_fullStr | Infectious Prophylaxis with Intrawound Vancomycin Powder in Orthopedic Surgeries: Systematic Review with Meta-Analysis |
| title_full_unstemmed | Infectious Prophylaxis with Intrawound Vancomycin Powder in Orthopedic Surgeries: Systematic Review with Meta-Analysis |
| title_short | Infectious Prophylaxis with Intrawound Vancomycin Powder in Orthopedic Surgeries: Systematic Review with Meta-Analysis |
| title_sort | infectious prophylaxis with intrawound vancomycin powder in orthopedic surgeries systematic review with meta analysis |
| topic | vancomycin surgical wound infection orthopedics |
| url | http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0102-36162019000600617&tlng=pt |
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