Intrawound Vancomycin Powder Reduces Surgical Site Infection And No Influence On Fusion Rate In Instrumented Lumbar Fusions

Objectivethis study was a retrospective case-control study of the effect of vancomycin on incision site and intervertebral space for surgical site infection after lumbar posterior fusion,and its safety and effectiveness,and whether it had any influence on the fusion rate.MethodRetrospective analysis of the Department of orthopedics of the First Affiliated Hospital of Zhejiang University Medical College from January 2014-2015 year in December the posterior lumbar fusion surgery were excluded patients with age,gender,history,statistical difference(P>0.05),in order to eliminate the partial test hill,all patients were in the same operation room,with a knife the doctor finishes,half an hour before surgery with conventional cefuroxime intravenous infusion of 2.0G,prevention of infection,all patients after routine placement of drainage tube.The use of vancomycin as the experimental group incision powder(group A),the experimental group was divided into two subgroups,A1 group is simply cut in the application of vancomycin powder 2 grams,A2 group is in the incision of vancomycin powder 1 grams,0.5 grams of intervertebral bone graft,0.5 grams of powder;without the use of vancomycin as the control group(B group),control the incidence of the experimental group and the control group and the experimental group SSI BMI,neurological status,comorbidities and complications difference.ResultsA total of 156 patients who met the research criteria were excluded.Excluding age,BMI,complications,estimated blood loss and operative time,the influencing factors were N=75 in the experimental group and N=81 in the control group.A total of 6 patients were infected after operation.The experimental group was 1/75=.3%and the control group was 5/81=6.1(P=0.006);in the experimental group,a case of infection was found in group A1,and there was no 0/38=0%(P=0.002)in the group of 1/37=2.7%and A2.In the experimental group,there was no obvious adverse reaction in the control group and the experimental group.The patients in the experimental group and the control group and the experimental group were clearly fused according to the standard of spinal fusion.Conclusionit is a safe and effective method to prevent surgical site infection after lumbar posterior fusion and internal fixation,and to apply vancomycin powder in incision and intervertebral space,and has no effect on intervertebral fusion rate.