Topical Vancomycin for Prevention of Surgical Site Infection after Craniotomy: Meta-analysis and Systematic Literature Review

Saleh, Ahmed; Thabet, Abdulnasser; Belkhair, Sirajeddin

doi:10.1016/j.wneu.2021.11.018

Cited by 2 publications

(2 citation statements)

References 16 publications

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“…However, additional studies are still required to demonstrate these prospective associations and to associate the impact of intrawound vancomycin on the consequences studied. This was suggested also in previous similar meta-analyses study which showed similar promising outcomes [25][26][27][28][29][30][31] Well-conducted randomised controlled trials are needed to assess these factors and the combination of different ages, gender, ethnicity, and other variants of subjects; because our meta-analysis study could not answer whether different gender, ages, and ethnicity are related to the results.…”

Section: Discussionmentioning

confidence: 71%

A meta‐analysis examined the effect of intrawound vancomycin on surgical site wound infections in non‐spinal neurosurgical operation

Zeng

Yang

Zhang

et al. 2022

International Wound Journal

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To assess the impact of intrawound vancomycin on surgical site wound infections in non‐spinal neurosurgical operations, we conducted a meta‐analysis. A thorough review of the literature up to September 2022 showed that 4286 participants had a non‐spinal neurosurgical operation at the start of the investigations; 1975 of them used intrawound vancomycin, while 2311 were control. Using dichotomous or contentious methods and a random or fixed‐effect model, odds ratios (OR) and mean difference (MD) with 95% confidence intervals (CIs) were estimated to evaluate the impact of intrawound vancomycin on surgical site wound infections in non‐spinal neurosurgical operation. The intrawound vancomycin had significantly lower surgical site wound infections (OR, 0.28; 95% CI, 0.19‐0.40; P < .001) with low heterogeneity (I2 = 32%) compared with the control in non‐spinal neurosurgical operation. The intrawound vancomycin had significantly lower surgical site wound infections compared with control in non‐spinal neurosurgical operation. The low sample size of 2 out of 13 researches in the meta‐analysis calls for care when analysing the results.

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Section: Discussionmentioning

confidence: 71%

A meta‐analysis examined the effect of intrawound vancomycin on surgical site wound infections in non‐spinal neurosurgical operation

Zeng

Yang

Zhang

et al. 2022

International Wound Journal

View full text Add to dashboard Cite

show abstract

“…The patients in this study experienced no adverse events associated with the use of intrawound vancomycin, which is consistent with other published studies including cardiac and cranial surgeries. 7,22,24,25 However, several local (wound dehiscence, wound seroma, delayed wound healing, neuritis, and pseudoarthrosis) and systemic (anaphylactic reaction, renal toxicity, and ototoxicity) adverse events have been reported in spinal and orthopedic surgeries in which the effect and safety of intrawound vancomycin powder were most extensively evaluated. 5,6,8,11,17,21 Therefore, as recommended in these surgical fields, minimizing the amount of vancomycin powder and hemovac line placement for avoiding an over-concentration of vancomycin in the wound can be helpful for reducing adverse events.…”

Section: Discussionmentioning

confidence: 99%

Intrawound Vancomycin Powder Application for Preventing Surgical Site Infection Following Cranioplasty

Youn¹,

Hwang²,

Kim³

et al. 2023

J Korean Neurosurg Soc

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Objective : Surgical site infection is the most detrimental complication following cranioplasty. In other surgical fields, intrawound vancomycin powder application has been introduced to prevent surgical site infection and is widely used based on results in multiple studies. This study evaluated the effect of intrawound vancomycin powder in cranioplasty compared with the conventional method without topical antibiotics.Methods : This retrospective study included 580 patients with skull defects who underwent cranioplasty between August 1, 1998 and December 31, 2021. The conventional method was used in 475 (81.9%; conventional group) and vancomycin powder (1g) was applied on the dura mater and bone flap in 105 (18.1%; vancomycin powder group) patients. Surgical site infection was defined as infection of the incision, organ, or space that occurred after cranioplasty. Surgical site infection within one-year surveillance period was compared between the conventional and vancomycin powder groups with logistic regression analysis. Penalized likelihood estimation method was used in logistic regression to deal with zero events. All local and systemic adverse events associated with topical vancomycin application were also evaluated.Results : Surgical site infection occurred in 31 (5.3%) patients and all were observed in the conventional group. The median time between cranioplasty and detection of surgical site infection was 13 days (range, 4 -333). Staphylococci were the most common organisms and identified in 25 (80.6%) of 31 cases with surgical site infections. The surgical site infection rate in the vancomycin powder group (0/105 [0%]) was significantly lower than that in the conventional group (31/475 [6.5%]; crude odds ratio 0.067 [95% confidence interval 0.006 -0.762], adjusted odds ratio 0.068 [95% confidence interval 0.006 -0.731]; p=0.026). No adverse events associated with intrawound vancomycin powder were observed during the follow-up. Conclusion :Intrawound vancomycin powder effectively prevented surgical site infections following cranioplasty without local or systemic adverse events. Our results suggest that intrawound vancomycin powder is an effective and safe strategy for patients undergoing cranioplasty.

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Topical Vancomycin for Prevention of Surgical Site Infection after Craniotomy: Meta-analysis and Systematic Literature Review

Cited by 2 publications

References 16 publications

A meta‐analysis examined the effect of intrawound vancomycin on surgical site wound infections in non‐spinal neurosurgical operation

A meta‐analysis examined the effect of intrawound vancomycin on surgical site wound infections in non‐spinal neurosurgical operation

Intrawound Vancomycin Powder Application for Preventing Surgical Site Infection Following Cranioplasty

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