[Application of vancomycin powder into the wound during spine surgery: systematic review and meta-analysis].
OBJECTIVE
To determine the effects of applying vancomycin powder within the surgical wound on the risk of surgical infections, pseudo-arthrosis and adverse events, in patients undergoing spinal surgery.


METHODS
A meta-analysis was carried out, including controlled studies that evaluated the risk of postoperative infections and/or pseudo-arthrosis in patients undergoing spinal surgery in which vancomycin powder was applied within the surgical wound.


RESULTS
were presented as pooled relative risks, with its 95% confidence intervals. Additionally, the frequency of complications attributable to vancomycin was also assessed.


RESULTS
A total of six controlled studies (3,379 subjects) were included. Pooled relative risks were: surgical site infection, 0.11 (95%CI: 0.05-0.25; P<.00001), and pseudo-arthrosis, 0.87 (95%CI; 0.34-2.21; P=.77). No statistically significant heterogeneity was found in both analyses. In 1,437 patients treated with vancomycin, there were no recorded vancomycin-related adverse events.


CONCLUSIONS
Application of vancomycin powder into the wound was associated with a significantly reduced risk of surgical site infections, without increasing pseudo-arthrosis or adverse events. However, randomized controlled trials are needed, in order to confirm the present results and make recommendations with more certainty.
Grupo de Investigación en Ciencias de la Salud y Neurociencias (CISNEURO), Cartagena de Indias, Colombia; Departamento de Neurocirugía, Universidad de Cartagena, Cartagena de Indias, Colombia. Electronic address: cisneuro.investigacion@gmail.com.
G
G
Alcalá-Cerra
Grupo de Investigación en Ciencias de la Salud y Neurociencias (CISNEURO), Cartagena de Indias, Colombia.
A J
AJ
Paternina-Caicedo
Grupo de Investigación en Ciencias de la Salud y Neurociencias (CISNEURO), Cartagena de Indias, Colombia.
L R
LR
Moscote-Salazar
Grupo de Investigación en Ciencias de la Salud y Neurociencias (CISNEURO), Cartagena de Indias, Colombia.
J J
JJ
Gutiérrez-Paternina
Grupo de Investigación en Ciencias de la Salud y Neurociencias (CISNEURO), Cartagena de Indias, Colombia.
L M
LM
Niño-Hernández
D000900:Anti-Bacterial Agents / Q000008:administration & dosage*; D006801:Humans; D007430:Intraoperative Care / Q000379:methods*; D019637:Orthopedic Procedures; D011208:Powders; D013131:Spine / Q000601:surgery*; D013530:Surgical Wound Infection / Q000517:prevention & control*; D014640:Vancomycin / Q000008:administration & dosage*
D000900:Anti-Bacterial Agents; D011208:Powders; D014640:Vancomycin
Cirugía; Columna vertebral; Herida; Infección; Infection; Instrumentación; Instrumentation; Spine; Surgery; Vancomicina; Vancomycin; Wound