Effect of Topical Vancomycin on Prevention of Surgical Site Infection in Spinal Surgery

Background and purpose: Surgical site infection (SSI) is one of the most commonly reported post-operative condition. The purpose of this study was to evaluate the effect of topical vancomycin powder on prevention of SSI in spinal surgery. Materials and methods: A single blind clinical trial was performed in 200 patients who were randomly divided into two groups. In both groups IV injection of cefazolin was done before the surgery and 24 hours later, but in case group, vancomycin powder was used before wound closure. The condition was examined for two weeks, one month and two months after the operation. In suspected cases of SSI, wound culture was done and ESR and CRP levels were also measured. Results: In current study, no significant relationship was found between the incidence of infection and age (P=0.038). Increased BMI in weeks two and four increased the incidence of SSI in both groups. The diagnosis and type of surgery did not correlate with post-operative infection. (P=0.635) There was no significant correlation between the two groups in CRP and ESR levels within the time studied (P=0.311). However, post-operative wound healing was significantly slower in case group (P=0.041). Conclusion: Vancomycin powder as a prophylactic treatment at incision was not found to change the risk of infection. Therefore, further studies are suggested to focus on one type of surgery merely.   (Clinical Trials Registry Number: IRCT20180826040869N1)