Evidence map›Paper›PMID 28699136›Full record

Trial reportMusculoskeletal surgery2018

Intrawound application of vancomycin changes the responsible germ in elective spine surgery without significant effect on the rate of infection: a randomized prospective study.

B Mirzashahi, M Chehrassan, S M J Mortazavi

Abstract readRandomized Controlled Trial
PubMed Publisher
In one paragraph

Trial report in Musculoskeletal surgery, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 30 papers, 8 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
30citing papers in PubMed, 8 pooled it
4.7field-weighted citation impact, top 5% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

30 citing papers in PubMed, 8 syntheses or guidelines pooled it, 56 citations in OpenAlex.

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  8. Meta-analysis of topical vancomycin powder for microbial profile in spinal surgical site infections.European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society · 2019
    Pooled it
  9. Local vancomycin therapy to reduce surgical site infection in adult spine surgery: a randomized prospective study.European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society · 2022
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  17. Local administration of vancomycin powder in orthopaedic fracture surgery: current practice and trends.OTA international : the open access journal of orthopaedic trauma · 2023
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4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

3 authors at 3 institutions in 3 countries.

B MirzashahiOrthopedic Department of Imam Hospital, Tehran University of Medical Sciences, Tehran, Iran.
M ChehrassanRizzoli Orthopaedic Institute, Bologna, Italy. morchehrasan@yahoo.com.ORCID http://orcid.org/0000-0002-3068-9764
S M J MortazaviOrthopedic Department of Imam Hospital, Tehran University of Medical Sciences, Tehran, Iran.
Imam Khomeini Hospital · IRIstituto Ortopedico Rizzoli · ITTehran University of Medical Sciences · IR

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeSurgical site infection (SSI) is a costly complication associated with spine surgery. The impact of intrawound vancomycin has not been strongly postulated to decrease the risk of surgical site infection. We designed study to determine whether intrawound vancomycin application reduces the risk of SSI in patients after spine surgery.

methodsA prospective randomized control trial study to evaluate the patients with elective spine surgery in a period of 15 month was designed. Patients were divided into two groups based on whether intrawound vancomycin was applied or not. The relative risk of SSI within postoperative 30 days was evaluated.

resultsThree hundred and eighty patients were included in this study: degenerative spine pathologies and tumor 80% (304), trauma 11% (42) and deformity 9% (34). Intrawound vancomycin was used in 51% of patients. Prevalence of SSI was 2.7% in the absence of vancomycin use versus 5.2% with intrawound vancomycin. In multivariable regression model, those with higher number of levels exposed, postoperative ICU admission and obesity and use of instrumentation more than two levels had higher risk of developing SSI. In the treatment group Acinetobacter and Pseudomonas aeruginosa (20%) were the most common pathogens. In control group, Staphylococcus aureus and Acinetobacter (40%) were the most common organisms.

conclusionsIntrawound application of vancomycin after elective spine surgery was not associated with reduced risk of SSI and return to OR associated with SSI in our patients. However, the use of intrawound vancomycin changed the responsible infection germ.

Indexed as

Elective Surgical ProceduresAnti-Bacterial AgentsFemaleHumansInjections, IntralesionalMaleProspective StudiesSpinal DiseasesSurgical Wound InfectionTreatment OutcomeVancomycinAnti-Bacterial AgentsVancomycinElective spine surgeryIntrawound vancomycinSpine infection

Identifiers

PMID28699136
OpenAlexW2735491264

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.