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Topical vancomycin surgical prophylaxis in pediatric open craniotomies: an institutional experience.

Publication ,  Journal Article
Ho, AL; Cannon, JGD; Mohole, J; Pendharkar, AV; Sussman, ES; Li, G; Edwards, MSB; Cheshier, SH; Grant, GA
Published in: J Neurosurg Pediatr
December 1, 2018

OBJECTIVETopical antimicrobial compounds are safe and can reduce cost and complications associated with surgical site infections (SSIs). Topical vancomycin has been an effective tool for reducing SSIs following routine neurosurgical procedures in the spine and following adult craniotomies. However, widespread adoption within the pediatric neurosurgical community has not yet occurred, and there are no studies to report on the safety and efficacy of this intervention. The authors present the first institution-wide study of topical vancomycin following open craniotomy in the pediatric population.METHODSIn this retrospective study the authors reviewed all open craniotomies performed over a period from 05/2014 to 12/2016 for topical vancomycin use, SSIs, and clinical variables associated with SSI. Topical vancomycin was utilized as an infection prophylaxis and was applied as a liquid solution following replacement of a bone flap or after dural closure when no bone flap was reapplied.RESULTSOverall, 466 consecutive open craniotomies were completed between 05/2014 and 12/2016, of which 43% utilized topical vancomycin. There was a 1.5% SSI rate in the nontopical cohort versus 0% in the topical vancomycin cohort (p = 0.045). The number needed to treat was 66. There were no significant differences in risk factors for SSI between cohorts. There were no complications associated with topical vancomycin use.CONCLUSIONSRoutine topical vancomycin administration during closure of open craniotomies can be a safe and effective tool for reducing SSIs in the pediatric neurosurgical population.

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Published In

J Neurosurg Pediatr

DOI

EISSN

1933-0715

Publication Date

December 1, 2018

Volume

22

Issue

6

Start / End Page

710 / 715

Location

United States

Related Subject Headings

  • Vancomycin
  • Treatment Outcome
  • Surgical Wound Infection
  • Retrospective Studies
  • Neurology & Neurosurgery
  • Male
  • Infant
  • Humans
  • Female
  • Craniotomy
 

Citation

APA
Chicago
ICMJE
MLA
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Ho, A. L., Cannon, J. G. D., Mohole, J., Pendharkar, A. V., Sussman, E. S., Li, G., … Grant, G. A. (2018). Topical vancomycin surgical prophylaxis in pediatric open craniotomies: an institutional experience. J Neurosurg Pediatr, 22(6), 710–715. https://doi.org/10.3171/2018.5.PEDS17719
Ho, Allen L., John G. D. Cannon, Jyodi Mohole, Arjun V. Pendharkar, Eric S. Sussman, Gordon Li, Michael S. B. Edwards, Samuel H. Cheshier, and Gerald A. Grant. “Topical vancomycin surgical prophylaxis in pediatric open craniotomies: an institutional experience.J Neurosurg Pediatr 22, no. 6 (December 1, 2018): 710–15. https://doi.org/10.3171/2018.5.PEDS17719.
Ho AL, Cannon JGD, Mohole J, Pendharkar AV, Sussman ES, Li G, et al. Topical vancomycin surgical prophylaxis in pediatric open craniotomies: an institutional experience. J Neurosurg Pediatr. 2018 Dec 1;22(6):710–5.
Ho, Allen L., et al. “Topical vancomycin surgical prophylaxis in pediatric open craniotomies: an institutional experience.J Neurosurg Pediatr, vol. 22, no. 6, Dec. 2018, pp. 710–15. Pubmed, doi:10.3171/2018.5.PEDS17719.
Ho AL, Cannon JGD, Mohole J, Pendharkar AV, Sussman ES, Li G, Edwards MSB, Cheshier SH, Grant GA. Topical vancomycin surgical prophylaxis in pediatric open craniotomies: an institutional experience. J Neurosurg Pediatr. 2018 Dec 1;22(6):710–715.

Published In

J Neurosurg Pediatr

DOI

EISSN

1933-0715

Publication Date

December 1, 2018

Volume

22

Issue

6

Start / End Page

710 / 715

Location

United States

Related Subject Headings

  • Vancomycin
  • Treatment Outcome
  • Surgical Wound Infection
  • Retrospective Studies
  • Neurology & Neurosurgery
  • Male
  • Infant
  • Humans
  • Female
  • Craniotomy