Scholarlink

<p>Surgical site infections (SSIs) occur in 1–14% of spine surgeries, especially thoracic procedures, with methicillin-resistant Staphylococcus aureus (MRSA) as a primary pathogen. Due to antibiotic resistance concerns, powdered vancomycin application offers a promising alternative by providing high local concentrations with minimal systemic effects. Despite its potential, efficacy evidence remains controversial, with concerns about side effects and resistance development. This PRISMA-guided systematic review evaluates powdered vancomycin’s effectiveness in preventing SSIs in posterior thoracic and lumbar spine surgeries through analysis of randomized clinical trials. This meta-analysis evaluated powdered vancomycin in preventing surgical site infections in posterior thoracic/lumbar spine surgeries using the PICO framework. The study included randomized trials comparing topical vancomycin to standard techniques, with searches conducted in PubMed, Cochrane Library, Web of Science, and Embase databases through 2024. Two independent reviewers performed study selection and data extraction. The analysis utilized RevMan<sup>®</sup> 5.4 software to calculate Relative Risk (RR) and 95% Confidence Interval (95% CI), applying the Mantel-Haenszel fixed-effects model for results synthesis. Methodological quality was assessed using Risk of Bias 2.0. The review was registered in PROSPERO (CRD420250655363). Following PRISMA 2020 guidelines, this meta-analysis included 5 randomized trials with 1,677 total patients (827 experimental, 850 control). Powdered vancomycin significantly reduced surgical site infections, with only 16 events versus 34 in the control group (risk ratio 0.48, 95% CI: 0.27–0.86, <i>p</i> = 0.01). Study heterogeneity was moderate (I²=33%), justifying the fixed-effect Mantel-Haenszel model. While findings suggest powdered vancomycin effectively prevents SSIs in posterior thoracic/lumbar spine surgeries, further validation across diverse populations and clinical settings remains necessary. Based on these results, the findings indicate that powdered vancomycin may reduce surgical site infections in spine surgeries. There was a significant reduction in SSIs; however, long-term safety requires further studies to validate its clinical adoption.</p>

错误：搜索内容不能为空，请输入英文关键词
错误：关键词超出字数限制，请精简
高级检索

Efficacy of powdered vancomycin in the prophylaxis of surgical site infections in posterior thoracic and/or lumbar spine surgery: a systematic review of randomized clinical trials with meta-analysis

  • 期刊论文

  • 发表日期：

    2025年11月28日

查看全文
  • Andréa Fortes Carvalho Barreto,
  • João Henrique Carvalho de Jesus,
  • José Calasans dos Santos,
  • Bruno Fernandes de Oliveira Santos

摘要

Surgical site infections (SSIs) occur in 1–14% of spine surgeries, especially thoracic procedures, with methicillin-resistant Staphylococcus aureus (MRSA) as a primary pathogen. Due to antibiotic resistance concerns, powdered vancomycin application offers a promising alternative by providing high local concentrations with minimal systemic effects. Despite its potential, efficacy evidence remains controversial, with concerns about side effects and resistance development. This PRISMA-guided systematic review evaluates powdered vancomycin’s effectiveness in preventing SSIs in posterior thoracic and lumbar spine surgeries through analysis of randomized clinical trials. This meta-analysis evaluated powdered vancomycin in preventing surgical site infections in posterior thoracic/lumbar spine surgeries using the PICO framework. The study included randomized trials comparing topical vancomycin to standard techniques, with searches conducted in PubMed, Cochrane Library, Web of Science, and Embase databases through 2024. Two independent reviewers performed study selection and data extraction. The analysis utilized RevMan® 5.4 software to calculate Relative Risk (RR) and 95% Confidence Interval (95% CI), applying the Mantel-Haenszel fixed-effects model for results synthesis. Methodological quality was assessed using Risk of Bias 2.0. The review was registered in PROSPERO (CRD420250655363). Following PRISMA 2020 guidelines, this meta-analysis included 5 randomized trials with 1,677 total patients (827 experimental, 850 control). Powdered vancomycin significantly reduced surgical site infections, with only 16 events versus 34 in the control group (risk ratio 0.48, 95% CI: 0.27–0.86, p = 0.01). Study heterogeneity was moderate (I²=33%), justifying the fixed-effect Mantel-Haenszel model. While findings suggest powdered vancomycin effectively prevents SSIs in posterior thoracic/lumbar spine surgeries, further validation across diverse populations and clinical settings remains necessary. Based on these results, the findings indicate that powdered vancomycin may reduce surgical site infections in spine surgeries. There was a significant reduction in SSIs; however, long-term safety requires further studies to validate its clinical adoption.