Vancomycin powder for the prevention of surgical site infection in posterior elective spinal surgery

Abstract Objective To assess the effectiveness and safety of vancomycin powder as surgical siteinfection (SSI) prophylaxis in posterior bilateral elective spinal surgery. Materials and methods Single-center quasi-experimental pre and postintervention compa-rative cohort study. The post-intervention group received standard intravenous antibioticprophylaxis plus 1 g of vancomycin powder into the surgical field before wound closure, andthe pre-intervention group only the intravenous prophylaxis. Results 150 patients were included in each group. Twelve SSI (7 superficial and 5 deep)occurred in the post-intervention group and 16 SSI (7 superficial and 9 deep) in the pre-intervention group. The risk of deep SSI decreased from 6.0% to 3.3% (OR 0,54, 95%CI 0.17-1.65, p = 0.411) with vancomycin powder. The percentage of deep SSI due to gramnegative-positive germs were 80%-20% and 33%–67% for the post- and pre-interventiongroups, respectively (p = 0.265). No local or systemic adverse effects occurred attributableto vancomycin powder. Conclusion In posterior elective spinal surgery, prophylaxis with vancomycin powder didnot result in a significantly reduced incidence of superficial and deep SSI. There was a trendtowards a higher incidence of deep SSI caused by gram negative microorganisms amongthose treated with vancomycin.