[Local administration of vancomycin powder in posterior lumbar fusion surgery].

AIM: To evaluate an efficacy of local administration of vancomycin powder in posterior lumbar fusion surgery for prevention of local infection.

MATERIAL AND METHODS: The study included 214 patients. All patients were divided into 2 groups: I group (control) and II (experimental). Patients of the first group underwent conventional antibiotic prophylaxis of wound infections, in group II traditional antibiotic prophylaxis was supplemented by local administration of vancomycin powder 1 g prior to wound closure.

RESULTS: There were 12 cases of wound infection in group I and 5 cases in group II. There were significant differences in overall incidence of wound infection and wound infections caused by S. aureus (p=0.035; p=0.044, respectively). Significant risk factors of local infection were determined in group II: obesity, diabetes mellitus, arterial hypertension, coronary artery disease, length of hospital-stay and previous lumbosacral spinal surgery. Multivariate analysis revealed following risk factors of wound infection: diabetes mellitus, arterial hypertension, coronary artery disease, the number of involved spinal segments and previous lumbosacral spinal surgery.

CONCLUSION: Local application of vancomycin powder in posterior lumbar fusion surgery significantly reduces the incidence of wound infection.