| Purpose:To perform the analysis the characterization of the bacteria in wound infection with respect to the patient who received the surgery due to lumbar degenerative diseases ranging from Feb.1,2012 to Dec.31,2015 in the department of spine surgery at the First people’s hospital of Huaihua.And to summarize the relative literatures published with Chinese language with revelation of infected bacteria.Measures:To make collection of results of bacterial culture and antibiotic sensitivity test in infected populations accepted the surgery at above hospital.Besides,the published literatures were also searched in the databases,such as CNKI and WANFANG MED ONLINE,which were relation to postoperative wound infection of spine surgery.Results:Total 36 cases occurred the postoperative wound infection accounting for 8.5%.Positive results occurred in 8 patients with Pus cultures included 3 cases of Staphylococcus aureus(S.Aureus),3 cases of Escherichia coli(E.Coli),one case of Pseudomonas aeruginosa(P Aeruginosa),and 1 case of Enterobacter agglomerans(E.Agglomerans).Notably,systematic review revealed the fact that the majority of infective bacteria are Staphylococci for postsurgical wound infection in spine surgery.Conclusion:The identical results were revealed by us like the consequence of foreign researches.Thus,using intrawound vancomycin powder in spinal surgery may be the valuable prophylactic method for Chinese people.Purpose:To investigate the effectiveness of the prophylactic intra-wound vancomycin powder for preventing the postoperative surgical site infection in spine surgery,and to explore the efficacy for this prophylactic measure basing on the subgroup of dosage.Measures:To search the clinical literatures relating to the spinal surgery and intrawound vancomycin powder deriving from the following databases,such as the PubMed/MEDLINE,the Google Scholar,the CNKI,the WANFANG MED ONLINE,and the VIP NET.The expiration date is Jan.1,2018.According to the inclusive and exclusive criterion,the dependent clinical orthopedic surgeons perforam selection and evaluation,and grasp the data for the articles.Results:Total 29 literatures consisting of 27 retrospective studies and 2 randomized study were included in this meta-analysis.The result revealed that the prophylactic topical vancomycin powder shows its benefit for preventing postoperative wound site infection(I2=5 9.8%,P=0.000,OR=2.51,95%CI[1.76-3.57]).However,the different results were confirmed by the subgroup analysis of dosage in this study,more effective in patients accepted 2g vancomycin powder.Conclusion:It shows the benefit for preventing post-surgical site infection in spinal surgery.It is crucial to pay attention to investigate the dosage and method of usage with prospective,randomized control research for the future.Purpose:To investigate the efficacy of the using topical vancomycin powder in lumbar surgery and to perform analysis of the systematic serum and wound concentration of vancomycin drug.Measures:To review the data of the department of spine surgery with the date ranging Jan.1,2016 to Dec.31,2015,the population who accepted the spinal surgery due to the degenerative diseases.Besides,all cases of the degenerative diseases were reviewed from 2016 to 2017 at the department of minimally invasive orthopedic.In the control group(C-0 Group,total 39 case).At the same time,to compare the study group with other groups(C-1,C-2,C-3,C-4 Groups)were also performed analysis as the control groups with the date from the Jan.1,2012 to Dec.31,2015.All the patients received 1.0 gram Cefazolin with standard scenario for orthopedic surgery in treatment group.However,the intravenous antibiotic(lg Cefazolin)plus 0.5g topical vancomycin powder were used before the closure of the wound in treatment group(22 cases).Baseline characteristics,operative details,and rates of wound infection were compared between untreated patients and those who received vancomycin powder.At the same time,the liver and renal function,the local and systematic drug concentrations(POHl,POD1,POD2,POD3)also were compared before and later of spinal surgery.Results:A total 61 patients underwent posterior lumbar surgery between 2016 and 2017.Baseline and operative variables were similar between untreated patients(n = 39),and those who received vancomycin powder(n = 22).The infection rate fell from 5.1%to 0%(P = 0.420)following the introduction of vancomycin powder.The retrospective data of cases shows the fact that the total infection rate is 8.5%(36/425)at the department of spine surgery ranging from 2012 to 2015.The local drug concentration were much higher than systematic concentration(POH1:1116.0 ± 268.4 μ g/ml,POD1:389.6 ±73.9 μ g/ml,POD2:133.0±27.4 μg/ml,POD3:84.6 μ 19.2 μ g/ml).The majority of systematic concentration were under 2 μ g/ml.No complications attributable to vancomycin powder were identified,even if the local concentration reached up to 48.9 u g/ml(safe concentration:10 μ g/ml-20 μ g/ml).Lastly,no pseudarthrosis and delayed wound infection in the short-term follow-up time.The difference were noted in this research without wound infection happened in study group compared to the treatment group and the retrospective case analysis group with aging from 2012 year to 2015 year(Pi=0.365,P2=0.08,P3=0.211,P4=0.320).Conclusion:It should be used to preventing posterior wound infection in spinal surgery.And much researches like prospective,random control trails need to be performed in the future. |
