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