Commentary on: “Sterile Seroma Resulting from Multilevel XLIF Procedure as Possible Adverse Effect of Prophylactic Vancomycin Powder: A Case Report”

[摘要] Postoperative surgical site infection (SSI) is the second most common health care–associated infection in the United States, second only to urinary tract infections, and resulting in an estimated 8,205 deaths in 2002 alone.1 Furthermore, SSIs have been shown to result in a prolongation of hospital stay by 9.7 days and increase treatment cost by $20,842 per admission.2 As such, significant attention has been focused on means of reducing SSIs and their associated morbidity and excess health care costs. Gram-positive microorganisms are the most common cause of SSI following spine surgery.3 The use of prophylactic intrawound vancomycin powder has recently become a more common practice due to its ease of application, low cost, and ability to achieve high local concentrations with low systemic levels.45 A recent meta-analysis found that vancomycin powder was associated with a significant reduction in SSI (odds ratio: 0.19, 95% confidence interval: 0.09–0.38).6 Furthermore, cost analyses on patients undergoing lumbar fusion procedures have demonstrated that the use of vancomycin powder was associated with a cost savings of $438,165 per 100 spinal fusions performed.7

[学科分类] 外科医学