Department of Orthopedic Surgery, Liuzhou People's Hospital Affiliated to Guangxi Medical University, Liuzhou, 545006, China.
Department of Orthopedic Surgery, Zhongnan Hospital of Wuhan University, Wuhan, 430071, China.
J Orthop Surg Res. 2023 Apr 13;18(1):299. doi: 10.1186/s13018-023-03779-5.
Systemic vancomycin administration pre-operatively for the infection prophylaxis of spinal implant surgery remains unsatisfactory. This study aimed to explore the efficacy and dosage of local use of vancomycin powder (VP) in preventing surgical site infections after spinal implant surgery in a rat model.
Systemic vancomycin (SV; intraperitoneal injection, 88 mg/kg) or intraoperative intra-wound VP (VP0.5: 44 mg/kg, VP1.0: 88 mg/kg, VP2.0: 176 mg/kg) was applied after spinal implant surgery and methicillin-resistant S. aureus (MRSA; ATCC BAA-1026) inoculation in rats. General status, blood inflammatory biomarkers, microbiological and histopathological evaluation were performed during 2 weeks post-surgery.
No post-surgical deaths, wound complications and obvious signs of vancomycin adverse effects were observed. Bacterial counts, blood and tissue inflammation were reduced in the VP groups compared with the SV group. VP2.0 group showed better outcomes in weight gain and tissue inflammation than the VP0.5 and VP1.0 group. Microbial counts indicated that no bacteria survived in the VP2.0 group, whereas MRSA was detected in VP0.5 and VP1.0 groups.
Intra-wound VP may be more effective than systemic administration in preventing infection caused by MRSA (ATCC BAA-1026) after spinal implant surgery in a rat model.
术前全身性万古霉素给药用于预防脊柱植入物手术的感染仍然不尽如人意。本研究旨在探讨万古霉素粉末（VP）局部应用在预防大鼠脊柱植入物手术后手术部位感染的疗效和剂量。
在大鼠脊柱植入物手术后和耐甲氧西林金黄色葡萄球菌（MRSA；ATCC BAA-1026）接种后，给予全身万古霉素（SV；腹腔注射，88mg/kg）或术中伤口内 VP（VP0.5：44mg/kg，VP1.0：88mg/kg，VP2.0：176mg/kg）。术后 2 周内进行一般状态、血液炎症生物标志物、微生物学和组织病理学评估。
术后无死亡、伤口并发症和明显的万古霉素不良反应迹象。与 SV 组相比，VP 组的细菌计数、血液和组织炎症减少。与 VP0.5 和 VP1.0 组相比，VP2.0 组在体重增加和组织炎症方面的效果更好。微生物计数表明，VP2.0 组无细菌存活，而 VP0.5 和 VP1.0 组检测到 MRSA。
与全身给药相比，伤口内 VP 可能更有效地预防大鼠脊柱植入物手术后由 MRSA（ATCC BAA-1026）引起的感染。
