PDF herunterladen
CC BY-NC-ND 4.0 · South Asian J Cancer 2017; 06(03): 099-101
DOI: 10.4103/2278-330X.214572
ORIGINAL ARTICLE : Bone and Soft Tissue Sarcomas

Topical vancomycin: Does it reduce surgical site infection in bone tumors?

Suman Byregowda
Department of Surgical Oncology, Tata Memorial Centre, Mumbai, Maharashtra
,
Ajay Puri
Department of Surgical Oncology, Tata Memorial Centre, Mumbai, Maharashtra
,
Ashish Gulia
Department of Surgical Oncology, Tata Memorial Centre, Mumbai, Maharashtra
› Institutsangaben Financial support and sponsorship: Nil.
› Weitere Informationen
Auch verfügbar auf
  als PDF herunterladen Lizenzen und Reprints

Abstract

Introduction: We retrospectively analyzed a consecutive group of patients operated for bone tumors of extremity and pelvis who received only perioperative antibiotics (Group A) against a similar group that had additional 1 g topical vancomycin sprinkled in the wound before closure (Group B). The aim was to determine if the addition of topical vancomycin decreases the incidence of deep surgical site infection (SSI). Materials and Methods: A total of 221 patients operated between January 2011 and December 2011 were analyzed in Group A and 254 patients operated between April 2012 and March 2013 were analyzed in Group B. Any patient who required operative intervention for wound discharge was considered to be infected. All patients had a 1 year follow-up to determine the incidence of SSI. Results: The overall rate of SSI was 7% (31 of 475 patients). Seventeen (8%) of Group A patients had SSI as against 14 (6 %) of Group B patients (P = 0.337). A subgroup analysis of endoprosthetic reconstructions, internal fixation implants (plates/intramedullary nails), extracorporeal radiation treated bones and strut allografts showed no difference between the two groups of patients. Conclusion: Our data suggest that the addition of topical vancomycin before wound closure in patients operated for bone tumors does not decrease the incidence of SSI. Further investigation of this technique using a case–controlled methodology with an increase in the dose of vancomycin may be warranted.

Key words

Antibiotics - endoprosthesis - surgical site infection - topical vancomycin


Publikationsverlauf

Artikel online veröffentlicht:
22. Dezember 2020

© 2017. MedIntel Services Pvt Ltd. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial-License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/.)

Thieme Medical and Scientific Publishers Pvt. Ltd.
A-12, 2nd Floor, Sector 2, Noida-201301 UP, India

 

  • References

  • 1 Ghert M, Deheshi B, Holt G, Randall RL, Ferguson P, Wunder J, et al. Prophylactic antibiotic regimens in tumour surgery (PARITY): Protocol for a multicentre randomised controlled study. BMJ Open 2012;2. pii: E002197.
  • 2 Blom AW, Taylor AH, Pattison G, Whitehouse S, Bannister GC. Infection after total hip arthroplasty. The Avon experience. J Bone Joint Surg Br 2003;85:956-9.
  • 3 Nagano S, Yokouchi M, Setoguchi T, Sasaki H, Shimada H, Kawamura I, et al. Analysis of surgical site infection after musculoskeletal tumor surgery: Risk assessment using a new scoring system. Sarcoma 2014;2014:645496.
  • 4 Hanssen AD, Osmon DR, Patel R. Local antibiotic delivery systems: Where are we and where are we going? Clin Orthop Relat Res 2005;437:111-4.
  • 5 Tubaki VR, Rajasekaran S, Shetty AP. Effects of using intravenous antibiotic only versus local intrawound vancomycin antibiotic powder application in addition to intravenous antibiotics on postoperative infection in spine surgery in 907 patients. Spine (Phila Pa 1976) 2013;38:2149-55.
  • 6 Chiang HY, Herwaldt LA, Blevins AE, Cho E, Schweizer ML. Effectiveness of local vancomycin powder to decrease surgical site infections: A meta-analysis. Spine J 2014;14:397-407.
  • 7 Sweet FA, Roh M, Sliva C. Intrawound application of vancomycin for prophylaxis in instrumented thoracolumbar fusions: Efficacy, drug levels, and patient outcomes. Spine (Phila Pa 1976) 2011;36:2084-8.
  • 8 Centre of Disease Control and Prevention Guidelines for Deep Surgical Site Infection. Available from: https://www.cdc.gov/nhsn/PDFs/pscManual/9pscSSIcurrent.pdf.
  • 9 Molinari RW, Khera OA, Molinari WJ 3rd. Prophylactic intraoperative powdered vancomycin and postoperative deep spinal wound infection: 1,512 consecutive surgical cases over a 6-year period. Eur Spine J 2012;21 Suppl 4:S476-82.
  • 10 Palumbo BT, Henderson ER, Groundland JS, Cheong D, Pala E, Letson GD, et al. Advances in segmental endoprosthetic reconstruction for extremity tumors: A review of contemporary designs and techniques. Cancer Control 2011;18:160-70.
  • 11 Jeys LM, Grimer RJ, Carter SR, Tillman RM. Risk of amputation following limb salvage surgery with endoprosthetic replacement, in a consecutive series of 1261 patients. Int Orthop 2003;27:160-3.
  • 12 Thonse R, Conway JD. Antibiotic cement-coated nails for the treatment of infected nonunions and segmental bone defects. J Bone Joint Surg Am 2008;90 Suppl 4:163-74.
  • 13 Martin JR, Adogwa O, Brown CR, Bagley CA, Richardson WJ, Lad SP, et al. Experience with intrawound vancomycin powder for spinal deformity surgery. Spine (Phila Pa 1976) 2014;39:177-84.
  • 14 Jeys LM, Grimer RJ, Carter SR, Tillman RM. Periprosthetic infection in patients treated for an orthopaedic oncological condition. J Bone Joint Surg Am 2005;87:842-9.
  • 15 Li X, Moretti VM, Ashana AO, Lackman RD. Perioperative infection rate in patients with osteosarcomas treated with resection and prosthetic reconstruction. Clin Orthop Relat Res 2011;469:2889-94.
  • 16 Natarajan MV, Sivaseelam A, Ayyappan S, Bose JC, Sampath Kumar M. Distal femoral tumours treated by resection and custom mega-prosthetic replacement. Int Orthop 2005;29:309-13.