Prophylaxis of Surgical Site Infection in Cranial Surgery with Vancomycin Powder Application into Wound

  • SAMI UR REHMAN Department of Neurosurgery, Shaheed Zulfiqar Ali Bhutto Medical University, PIMS, Islamabad
  • RIFFAT ULLAH KHAN Abbottabad Medical Complex,Abbottabd,Pakistan
  • GHAYUR ABBAS pakistan institute of medical sciences
  • USAMA BIN ZUBAIR pakistan institute of medical sciences
  • KAMRAN KHAN Abbottabad International Medical College,Abbottabad
  • SAJID NAZEER BHATTI pakistan institute of medical sciences
Keywords: Vancomycin, cranial surgery, surgical site infection

Abstract

Objective: To see the effect of application of Vancomycin powder directly into the subgaleal space in reducing the postoperative surgical site infections.
Materials and Methods: All the patients who underwent consecutive elective craniotomies from April 2017 to May 2018 Dept of Neurosurgery, szabmu, PIMS, Islamabad. The control group received the standard routine prophylaxis according to the hospital protocols, whereas the treatment group, in addition to the standard prophylaxis, received Vancomycin powder in the surgical wound in addition to the standard routine prophylaxis. 
Results: 182 patients were enrolled in the study, 91 allocated to each the control and treatment group (Vancomycin). Six patients were lost to follow up. There were 90 patients in the control group and 86 patients in the treatment (Vancomycin) group. Both the groups were almost statistically similar. In the control group, 34.09% (n = 60) were male and 17.04% (n = 30) were female. In the treatment group, 29.54% (n = 52) were male and 19.31% (n = 34) were female. The overall rate of surgical site infection (SSI) was 3.97% (7 out of 176 cases). A statistically significant difference found in infection rate between the treatment group, 0% (0 out of 86 cases) and the control group, 7.77% (7 out of 90 cases) with the p value of 0.002. 
Conclusions: The use of topical Vancomycin powder in surgical wounds may significantly reduce the incidence of infection in patients undergoing elective craniotomies. It is a promising means of preventing devastating and harmful postoperative wound infections.

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Published
2019-09-26
Section
Original Article