Local vancomycin in prevention of surgical site infection in spinal surgeries

Background: Organisms that cause surgical site infections (SSIs) can no longer be effectively prevented by antibiotic drugs due to resistance. Methicillin-resistant Staphylococcus aureus (MRSA) SSIs have become more prevalent to cure. Lyophilized vancomycin powder has been used locally as perioperative prophylactic antibiotics, right before the surgical wound is closed. The study's objective was to evaluate the local vancomycin administration to SSI prevention during spine operations.Methods: This randomized trial study was conducted on 42 patients above 18 years old who were subjected to lumbosacral, thoracic, or cervical open spinal surgery The patients were split into 2 groups: Treatment group: this group receives local application of vancomycin and placebo group: this group not get any topical antibiotics. Results: The ESR level at follow-up time post operatively there was no significant differences at any groups. However, there were reduction of ESR level in the treatment group. There were differences in CRP level between 2 groups at 10 days, 2weeks, and 8 weeks. In the treatment group we found most of our cases 13 (62%) with category A. There are 7 cases (33%) in category B and one case with category C. In the placebo group, we found most of our cases 11 (52%) cases with category A. There were 6 cases (29%) cases in category B and the remaining 3 cases (14%) of category C.Conclusions: We found that old age and diabetic patient should be applied with vancomycin. Ultrasound scan and MRI are a good way to detect infections. These outcomes suggest that using vancomycin intraoperatively reduced the incidence of SSIs following spine operations.