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Child's Nervous System

, Volume 35, Issue 1, pp 107–111 | Cite as

Topical vancomycin for surgical prophylaxis in non-instrumented pediatric spinal surgeries

  • John G. D. Cannon
  • Allen L. Ho
  • Jyodi Mohole
  • Arjun V. Pendharkar
  • Eric S. Sussman
  • Samuel H. Cheshier
  • Gerald A. GrantEmail author
Original Paper

Abstract

Study design

Retrospective cohort study.

Objective

To determine if topical vancomycin irrigation reduces the incidence of post-operative surgical site infections following pediatric spinal procedures.

Summary of background data

Surgical site infections (SSIs) following spinal procedures performed in pediatric patients represent a serious complication. Prophylactic use of topical vancomycin prior to closure has been shown to be effective in reducing incidence of SSIs in adult spinal procedures. Non-instrumented cases make up the majority of spinal procedures in pediatric patients, and the efficacy of prophylactic topical vancomycin in these procedures has not previously been reported.

Methods

This retrospective study reviewed all non-instrumented spinal procedures performed over a period from 05/2014–12/2016 for topical vancomycin use, surgical site infections, and clinical variables associated with SSI. Topical vancomycin was utilized as infection prophylaxis, and applied as a liquid solution within the wound prior to closure.

Results

Ninety-five consecutive, non-instrumented, pediatric spinal surgeries were completed between 01/2015 and 12/2016, of which the last 68 utilized topical vancomycin. There was a 11.1% SSI rate in the non-topical vancomycin cohort versus 0% in the topical vancomycin cohort (P = 0.005). The number needed to treat was 9. There were no significant differences in risk factors for SSI between cohorts. There were no complications associated topical vancomycin use.

Conclusions

Routine topical vancomycin administration during closure of non-instrumented spinal procedures can be a safe and effective tool for reducing SSIs in the pediatric neurosurgical population.

Keywords

Antibiotics Spine infection Non-instrumented spine Infection prophylaxis Surgical site infection Surgical prophylaxis Topical vancomycin Vancomycin powder Pediatric spinal surgery 

Notes

Compliance with ethical standards

Conflict of interest

The authors of this manuscript have no financial interest in the subject under discussion.

IRB approval

This work was approved by the Stanford IRB.

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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Department of NeurosurgeryStanford University School of MedicineStanfordUSA
  2. 2.Division of NeurosurgeryLucile Packard Children’s Hospital StanfordPalo AltoUSA

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