Infectious Prophylaxis with Intrawound Vancomycin Powder in Orthopedic Surgeries: Systematic Review with Meta-Analysis

Detalhes bibliográficos
Autor(a) principal: Sadigursky,David
Data de Publicação: 2019
Outros Autores: Sousa,Mariana Drummond, Cajaíba,Yasmin Galvão Linhares, Martins,Rodrigo Rêgo, Lobão,Diogo Maciel Vieira
Tipo de documento: Artigo
Idioma: eng
Título da fonte: Revista Brasileira de Ortopedia (Online)
Texto Completo: http://old.scielo.br/scielo.php?script=sci_arttext&pid=S0102-36162019000600617
Resumo: Abstract Despite many existing strategies used to reduce the rates of surgical site infection (SSI), these are still fairly frequent complications that pose a challenge for orthopedic surgeons. Therefore, the search for more effective methods of perioperative infection prophylaxis became a main subject of research, with the goal of decreasing postoperative morbidity, mortality, and costs. Thus, the present study sought to assess the effectiveness of intra-wound vancomycin powder in orthopedic surgery SSI prophylaxis. A systematic review and meta-analysis study was conducted using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Protocols 2015 (PRISMA-P 2015). A comprehensive literature search was performed to identify controlled studies on the rates of SSI with or without the local use of vancomycin powder. Exclusion and inclusion criteria were applied. A meta-analysis with random effects was performed. Out of 412 titles that met the criteria, 7 studies regarding spine surgery were included: 4 prospective and 3 retrospective studies. A total of 6,944 cases were identified, and they were divided into 2 groups: the control group (3,814 patients), to whom intrawound vancomycin was not administered, and the intervention group (3,130 patients), to who vancomycin was administered locally. We observed that 64 (2.04%) patients in the intervention group developed SSI, in contrast to 144 (3.75%) patients in the control group. The results of the meta-analysis showed that the local use of vancomycin powder had an statistically significant protective effect against SSI in cases of spine surgery, with a relative risk (RR) of 0.59 and a 95% confidence interval (95%CI) of 0.35-0.98. The use of prophylactic intrawound vancomycin powder has a protective effect against SSI in spine surgeries; however, further prospective trials are needed to endorse its use in orthopedic surgeries.
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spelling Infectious Prophylaxis with Intrawound Vancomycin Powder in Orthopedic Surgeries: Systematic Review with Meta-Analysisvancomycinsurgical wound infectionorthopedicsAbstract Despite many existing strategies used to reduce the rates of surgical site infection (SSI), these are still fairly frequent complications that pose a challenge for orthopedic surgeons. Therefore, the search for more effective methods of perioperative infection prophylaxis became a main subject of research, with the goal of decreasing postoperative morbidity, mortality, and costs. Thus, the present study sought to assess the effectiveness of intra-wound vancomycin powder in orthopedic surgery SSI prophylaxis. A systematic review and meta-analysis study was conducted using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Protocols 2015 (PRISMA-P 2015). A comprehensive literature search was performed to identify controlled studies on the rates of SSI with or without the local use of vancomycin powder. Exclusion and inclusion criteria were applied. A meta-analysis with random effects was performed. Out of 412 titles that met the criteria, 7 studies regarding spine surgery were included: 4 prospective and 3 retrospective studies. A total of 6,944 cases were identified, and they were divided into 2 groups: the control group (3,814 patients), to whom intrawound vancomycin was not administered, and the intervention group (3,130 patients), to who vancomycin was administered locally. We observed that 64 (2.04%) patients in the intervention group developed SSI, in contrast to 144 (3.75%) patients in the control group. The results of the meta-analysis showed that the local use of vancomycin powder had an statistically significant protective effect against SSI in cases of spine surgery, with a relative risk (RR) of 0.59 and a 95% confidence interval (95%CI) of 0.35-0.98. The use of prophylactic intrawound vancomycin powder has a protective effect against SSI in spine surgeries; however, further prospective trials are needed to endorse its use in orthopedic surgeries.Sociedade Brasileira de Ortopedia e Traumatologia2019-12-01info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersiontext/htmlhttp://old.scielo.br/scielo.php?script=sci_arttext&pid=S0102-36162019000600617Revista Brasileira de Ortopedia v.54 n.6 2019reponame:Revista Brasileira de Ortopedia (Online)instname:Sociedade Brasileira de Ortopedia e Traumatologia (SBOT)instacron:SBOT10.1016/j.rbo.2017.12.003info:eu-repo/semantics/openAccessSadigursky,DavidSousa,Mariana DrummondCajaíba,Yasmin Galvão LinharesMartins,Rodrigo RêgoLobão,Diogo Maciel Vieiraeng2019-12-09T00:00:00Zoai:scielo:S0102-36162019000600617Revistahttp://www.rbo.org.br/https://old.scielo.br/oai/scielo-oai.php||rbo@sbot.org.br1982-43780102-3616opendoar:2019-12-09T00:00Revista Brasileira de Ortopedia (Online) - Sociedade Brasileira de Ortopedia e Traumatologia (SBOT)false
dc.title.none.fl_str_mv Infectious Prophylaxis with Intrawound Vancomycin Powder in Orthopedic Surgeries: Systematic Review with Meta-Analysis
title Infectious Prophylaxis with Intrawound Vancomycin Powder in Orthopedic Surgeries: Systematic Review with Meta-Analysis
spellingShingle Infectious Prophylaxis with Intrawound Vancomycin Powder in Orthopedic Surgeries: Systematic Review with Meta-Analysis
Sadigursky,David
vancomycin
surgical wound infection
orthopedics
title_short Infectious Prophylaxis with Intrawound Vancomycin Powder in Orthopedic Surgeries: Systematic Review with Meta-Analysis
title_full Infectious Prophylaxis with Intrawound Vancomycin Powder in Orthopedic Surgeries: Systematic Review with Meta-Analysis
title_fullStr Infectious Prophylaxis with Intrawound Vancomycin Powder in Orthopedic Surgeries: Systematic Review with Meta-Analysis
title_full_unstemmed Infectious Prophylaxis with Intrawound Vancomycin Powder in Orthopedic Surgeries: Systematic Review with Meta-Analysis
title_sort Infectious Prophylaxis with Intrawound Vancomycin Powder in Orthopedic Surgeries: Systematic Review with Meta-Analysis
author Sadigursky,David
author_facet Sadigursky,David
Sousa,Mariana Drummond
Cajaíba,Yasmin Galvão Linhares
Martins,Rodrigo Rêgo
Lobão,Diogo Maciel Vieira
author_role author
author2 Sousa,Mariana Drummond
Cajaíba,Yasmin Galvão Linhares
Martins,Rodrigo Rêgo
Lobão,Diogo Maciel Vieira
author2_role author
author
author
author
dc.contributor.author.fl_str_mv Sadigursky,David
Sousa,Mariana Drummond
Cajaíba,Yasmin Galvão Linhares
Martins,Rodrigo Rêgo
Lobão,Diogo Maciel Vieira
dc.subject.por.fl_str_mv vancomycin
surgical wound infection
orthopedics
topic vancomycin
surgical wound infection
orthopedics
description Abstract Despite many existing strategies used to reduce the rates of surgical site infection (SSI), these are still fairly frequent complications that pose a challenge for orthopedic surgeons. Therefore, the search for more effective methods of perioperative infection prophylaxis became a main subject of research, with the goal of decreasing postoperative morbidity, mortality, and costs. Thus, the present study sought to assess the effectiveness of intra-wound vancomycin powder in orthopedic surgery SSI prophylaxis. A systematic review and meta-analysis study was conducted using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Protocols 2015 (PRISMA-P 2015). A comprehensive literature search was performed to identify controlled studies on the rates of SSI with or without the local use of vancomycin powder. Exclusion and inclusion criteria were applied. A meta-analysis with random effects was performed. Out of 412 titles that met the criteria, 7 studies regarding spine surgery were included: 4 prospective and 3 retrospective studies. A total of 6,944 cases were identified, and they were divided into 2 groups: the control group (3,814 patients), to whom intrawound vancomycin was not administered, and the intervention group (3,130 patients), to who vancomycin was administered locally. We observed that 64 (2.04%) patients in the intervention group developed SSI, in contrast to 144 (3.75%) patients in the control group. The results of the meta-analysis showed that the local use of vancomycin powder had an statistically significant protective effect against SSI in cases of spine surgery, with a relative risk (RR) of 0.59 and a 95% confidence interval (95%CI) of 0.35-0.98. The use of prophylactic intrawound vancomycin powder has a protective effect against SSI in spine surgeries; however, further prospective trials are needed to endorse its use in orthopedic surgeries.
publishDate 2019
dc.date.none.fl_str_mv 2019-12-01
dc.type.driver.fl_str_mv info:eu-repo/semantics/article
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dc.relation.none.fl_str_mv 10.1016/j.rbo.2017.12.003
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dc.publisher.none.fl_str_mv Sociedade Brasileira de Ortopedia e Traumatologia
publisher.none.fl_str_mv Sociedade Brasileira de Ortopedia e Traumatologia
dc.source.none.fl_str_mv Revista Brasileira de Ortopedia v.54 n.6 2019
reponame:Revista Brasileira de Ortopedia (Online)
instname:Sociedade Brasileira de Ortopedia e Traumatologia (SBOT)
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repository.name.fl_str_mv Revista Brasileira de Ortopedia (Online) - Sociedade Brasileira de Ortopedia e Traumatologia (SBOT)
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