title: Topical intrawound application of vancomycin powder in addition to intravenous administration of antibiotics: A meta-analysis on the deep infection after spinal surgeries.
abstract: BACKGROUND
  The intrawound application of vancomycin powder in addition to intravenous administration of antibiotics has been reported to be an easy and cost-efficient technique for reducing the deep infection, which is a serious complication of spinal surgeries. The aim of the present meta-analysis was to derive a preliminary estimation on the clinical performance of this technique.
  
  
  OBJECTIVE
  The intrawound application of vancomycin powder in addition to intravenous administration of antibiotics may significantly reduce the risk of deep infection after spinal surgeries.
  
  
  METHODS
  Studies were identified from PubMed and EMBASE searches. After comprehensive review, data were extracted from eligible studies. A meta-analysis was performed to generate pooled odds ratio (OR) of this technique.
  
  
  RESULTS
  Eight studies (4592 patients) were included. The pooled OR (95% CI) was 0.22 (0.07-0.63). I(2) value was 65.2% (P=0.005). The pooled ORs were stable in sensitivity analyses. No analysis of subgroup, meta-regression or publication bias was performed because of inadequate included studies.
  
  
  CONCLUSIONS
  The intrawound application of vancomycin powder in addition to intravenous administration of antibiotics may significantly reduce the risk of deep infection after spinal surgeries. Further studies with large sample size and high quality are needed to provide more evidences.
  
  
  METHODS
  II.
authors.affiliation: Department of Hand-, Plastic and Reconstructive Surgery, Burn Center, University of Heidelberg, BG Trauma Center Ludwigshafen, 67071 Ludwigshafen, Germany. Electronic address: xionglingyun1986@163.com.
authors.forename: L
authors.initials: L
authors.lastname: Xiong
authors.affiliation: Department of Pharmacy, the First Hospital of Yichang, China Three Gorges University, 443000 Yichang, China.
authors.forename: Q
authors.initials: Q
authors.lastname: Pan
authors.affiliation: Department of Pharmacy, the First Hospital of Yichang, China Three Gorges University, 443000 Yichang, China.
authors.forename: G
authors.initials: G
authors.lastname: Jin
authors.affiliation: Department of Pharmacy, the First Hospital of Yichang, China Three Gorges University, 443000 Yichang, China.
authors.forename: Y
authors.initials: Y
authors.lastname: Xu
authors.affiliation: Department of Hand-, Plastic and Reconstructive Surgery, Burn Center, University of Heidelberg, BG Trauma Center Ludwigshafen, 67071 Ludwigshafen, Germany.
authors.forename: C
authors.initials: C
authors.lastname: Hirche
mesh_terms: D000287:Administration, Topical; D000900:Anti-Bacterial Agents / Q000008:administration & dosage; D006801:Humans; D007275:Injections, Intravenous; D019637:Orthopedic Procedures / Q000009:adverse effects*; D011208:Powders; D013122:Spinal Diseases / Q000601:surgery*; D013530:Surgical Wound Infection / Q000188:drug therapy*; D014640:Vancomycin / Q000008:administration & dosage*
chemical_list: D000900:Anti-Bacterial Agents; D011208:Powders; D014640:Vancomycin
keywords: Deep infection; Intrawound; Spine; Vancomycin