Topical vancomycin for surgical prophylaxis in non-instrumented pediatric spinal surgeries.

Journal Article (Journal Article)

STUDY DESIGN: Retrospective cohort study. OBJECTIVE: To determine if topical vancomycin irrigation reduces the incidence of post-operative surgical site infections following pediatric spinal procedures. Surgical site infections (SSIs) following spinal procedures performed in pediatric patients represent a serious complication. Prophylactic use of topical vancomycin prior to closure has been shown to be effective in reducing incidence of SSIs in adult spinal procedures. Non-instrumented cases make up the majority of spinal procedures in pediatric patients, and the efficacy of prophylactic topical vancomycin in these procedures has not previously been reported. METHODS: This retrospective study reviewed all non-instrumented spinal procedures performed over a period from 05/2014-12/2016 for topical vancomycin use, surgical site infections, and clinical variables associated with SSI. Topical vancomycin was utilized as infection prophylaxis, and applied as a liquid solution within the wound prior to closure. RESULTS: Ninety-five consecutive, non-instrumented, pediatric spinal surgeries were completed between 01/2015 and 12/2016, of which the last 68 utilized topical vancomycin. There was a 11.1% SSI rate in the non-topical vancomycin cohort versus 0% in the topical vancomycin cohort (P = 0.005). The number needed to treat was 9. There were no significant differences in risk factors for SSI between cohorts. There were no complications associated topical vancomycin use. CONCLUSIONS: Routine topical vancomycin administration during closure of non-instrumented spinal procedures can be a safe and effective tool for reducing SSIs in the pediatric neurosurgical population.

Full Text

Duke Authors

Cited Authors

  • Cannon, JGD; Ho, AL; Mohole, J; Pendharkar, AV; Sussman, ES; Cheshier, SH; Grant, GA

Published Date

  • January 2019

Published In

Volume / Issue

  • 35 / 1

Start / End Page

  • 107 - 111

PubMed ID

  • 29955942

Electronic International Standard Serial Number (EISSN)

  • 1433-0350

Digital Object Identifier (DOI)

  • 10.1007/s00381-018-3881-z

Language

  • eng

Conference Location

  • Germany