Morgan E, Onuminya J E, Osime C O, Adebayo B O, Ehioghae O, Adetunmbi B
Department of Surgery, Irrua Specialist Teaching Hospital Irrua, Nigeria; Department of Surgery, Babcock University, Ilishan-Remo, Ogun state, Nigeria.
Department of Orthopedic Surgery, Ambrose Alli University Ekpoma, Nigeria.
J Clin Neurosci. 2024 Mar;121:155-160. doi: 10.1016/j.jocn.2024.02.008. Epub 2024 Feb 23.
The objective was to determine the efficacy of intraoperative vancomycin powder in preventing SSIs in neurological surgeries.
A prospective randomized controlled study of patients who had clean cranial and non-implant spine surgeries at the Irrua Specialist Teaching Hospital, Irrua, Nigeria from February 1, 2021 to January 31, 2022. Patients were randomized into two groups. Group A patients had prophylactic intraoperative vancomycin powder applied to the surgical bed before wound closure while group B patients did not. Patients in both groups were followed up for 30 days post-operatively for evidence of SSI. The occurrence of SSIs was determined using clinical and laboratory parameters. Baseline characteristics, operative details, rates of wound infection, and microbiological data for each case were recorded. Data was analyzed using Statistical Package for Scientific Solution (SPSS) version 23 software.
Forty-two patients were randomized into 2 groups of 21 patients each. The age range of the patients was 20 to 80 years. The majority of the patients were males (32 out of 42). The mean age of patients in group A was 48.05 ± 17.03 years, while group B had a mean age of 45.95 ± 19.14 years. The mean Body Mass Index of patients in groups A and B were 23.92 ± 5.21 and 23.21 ± 3.99 respectively. Seven out of 21 patients (33.3 %) in the control group ( group B) had superficial SSIs while no patient in the experimental group had SSI, p-value < 0.05. The organisms cultured were Klebsiella pneumoniae, Pseudomonas aeruginosa, and Staphylococcus aureus.
Intraoperative vancomycin powder was effective in reducing the rate of SSIs following neurological surgeries and without adverse drug reactions.
本研究旨在确定术中使用万古霉素粉末预防神经外科手术手术部位感染（SSIs）的疗效。
这是一项前瞻性随机对照研究，研究对象为2021年2月1日至2022年1月31日在尼日利亚伊鲁阿专科医院接受清洁颅脑和非植入性脊柱手术的患者。患者被随机分为两组。A组患者在伤口缝合前将预防性术中万古霉素粉末应用于手术创面，而B组患者未应用。两组患者术后均随访30天，以观察SSIs迹象。使用临床和实验室参数确定SSIs的发生情况。记录每个病例的基线特征、手术细节、伤口感染率和微生物学数据。使用科学解决方案统计软件包（SPSS）23版软件进行数据分析。
42例患者被随机分为两组，每组21例。患者年龄范围为20至80岁。大多数患者为男性（42例中的32例）。A组患者的平均年龄为48.05±17.03岁，而B组患者的平均年龄为45.95±19.14岁。A组和B组患者的平均体重指数分别为23.92±5.21和23.21±3.99。对照组（B组）21例患者中有7例（33.3%）发生浅表SSIs，而实验组无患者发生SSIs，p值<0.05。培养出的微生物为肺炎克雷伯菌、铜绿假单胞菌和金黄色葡萄球菌。
术中使用万古霉素粉末可有效降低神经外科手术后SSIs的发生率，且无药物不良反应。
