Impact of Powdered Vancomycin on Preventing Surgical Site Infections in Neurosurgery: A Systematic Review and Meta-analysis.

摘要: BACKGROUND Surgical site infections (SSIs) after spine and brain surgery present a major burden to patients hospitals by increasing morbidity, mortality, healthcare costs. OBJECTIVE To review available literature investigating the role of intrawound powdered vancomycin against SSIs neurosurgical operations. METHODS All randomized observational English language studies use in spinal cranial were included analyzed using random-effects modeling. RESULTS In (25 with 16 369 patients), group had significantly lower risk for any SSI (odds ratio [OR]: 0.41; 95% confidence interval [CI]: 0.30-0.57; P < .001; I2 = 47%). However, when separate analyses conducted superficial deep SSIs, significant difference was found only (OR: 0.31; CI: 0.22-0.45; 29%). Subgroup different powder dosages (1 g vs 2 composite dose) did not point dose-related effect vancomycin. (6 1777 associated 0.33; 0.18-0.60; P .0003; 45%). meta-regression analysis, trial-level variability diabetes no influence on association SSIs. CONCLUSION Use might be protective especially No identified. caution is needed clinical interpretation these results, owing design this meta-analysis.