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학술저널
저자정보
서보경 (한림대학교) 문성환 (연세대학교) 김태환 (한림대학교성심병원) 오재근 (한림대학교) 권용신 (한림대학교) 박정섭 (한림대학교) 박문수 (한림대학교)
저널정보
대한척추외과학회 Asian Spine Journal Asian Spine Journal Vol.9 No.4
발행연도
2015.1
수록면
517 - 521 (5page)

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Study Design: Retrospective study. Purpose: To evaluate the effect of intraoperative wound application of vancomycin on preventing surgical wound contamination during instrumented lumbar spinal surgery. Overview of Literature: Postoperative infection is the one of the most devastating complications of lumbar surgery. There are a few reports showing the benefits of intraoperative wound application of vancomycin during spinal surgery. However, there is no report about the effectiveness of local vancomycin instillation in prevention of surgical wound contamination. Methods: Eighty-six patients underwent instrumented lumbar spinal surgery. Mean patient age was 65.19 years (range, 23–83 years). There were 67 females and 19 males. During surgery, vancomycin powder was applied into the surgical site before closure in 43 patients (antibiotic group) and vancomycin powder was not applied into the surgical site before closure in 43 patients (control group). The tip of the surgical drain was cultured to evaluate surgical wound contamination. Erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) were measured on the first, third, seventh, and fourteenth day after the operation. Results: We found two patients with a positive culture from the tip of surgical drains in the antibiotic group, and one patient with a positive culture from the tip of the surgical drain in the control group. Postoperative ESR and CRP levels did not show significant differences between the two groups. On the third postoperative day, ESR in patients of the antibiotic group was more significantly decreased than that in patients of the control group, while CRP level did not show a significant difference between the two groups. Conclusions: There was no evidence to suggest that intraoperative vancomycin application is effective in decreasing the risk of postoperative wound infection after instrumented posterior lumbar fusion surgery.

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